Methodological assessment of behavioural problem dimensions in adults with dental fear

Methodological assessment of behavioural problem dimensions in adults with dental fear
Issue online:
21 May 2007
Submitted 13 October 2005; accepted 24 April 2006
To cite this article: Magnus L. Elfstrām, Jesper Lundgren, Ulf Berggren (2007)
Methodological assessment of behavioural problem dimensions in adults with dental fear
Community Dentistry and Oral Epidemiology 35 (3), 186Ō194.
doi:10.1111/j.1600-0528.2006.00312.x
Blackwell Synergy

Magnus L. Elfstrām11Health Care Research Unit, Institute of Medicine, Sahlgrenska Academy at Gāteborg University, Jesper Lundgren22Department of Psychology, Gāteborg University and Ulf Berggren33Dental Behavioural Sciences Unit, Institute of Odontology, Sahlgrenska Academy at Gāteborg University, Gāteborg, Sweden

Magnus L. Elfstrām, Health Care Research Unit, Bruna StrŦket 30, Sahlgrenska University Hospital, 413 45 Gāteborg, Sweden
Tel: +46 31 342 23 27
Fax: +46 41 85 27
e-mail: magnus.elfstrom@medicine.gu.se
Elfstrām ML, Lundgren J, Berggren U. Methodological assessment of behavioural problem dimensions in adults with dental fear. Community Dent Oral Epidemiol 2007; 35: 186Ō194. Š 2007 The Authors. Journal compilation Š 2007 Blackwell Munksgaard

Abstract
Objectives: In the assessment and treatment of persons with dental fear, there may be other psychological/behavioural factors than fear itself and traditional measures of psychopathology that should be considered. Longitudinal natural history studies are needed to find such variables. The present study investigated whether the same behavioural problem dimensions (internalizing, externalizing, attention) found among children and adolescents with behaviour management problems and/or dental fear could also be found among severely fearful adult patients.

Methods: The participants were 230 consecutive adult patients applying for treatment for severe dental anxiety at a specialized clinic. Patients completed a version of the Rutter behaviour questionnaire that was adapted for adults. Comparison data were the Hospital Anxiety and Depression scale and self-rated anger evoked by dental fear. Background data, including dental fear, were also collected. Descriptive statistics, principal components analyses, group comparisons and correlations were calculated.

Results: Of the three behaviour problems scales we adapted for adults, two (Internalizing and Attention) had acceptable psychometric properties and meaningful relations with the comparison variables. In contrast, the third problem scale (Externalizing) proved to have less satisfactory properties and relations, especially for men. Patients with severe phobia had higher levels of problem behaviours than patients with less severe phobia.

Conclusions: Internalizing and Attention scales for adults seem promising for use in future prospective studies of the natural history of dental fear. The Externalizing scale, however, needs to be studied with a wider range of comparison variables and measures of social desirability.

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