Psychometric properties of the modified dental anxiety scale: an independent replication

AIM

To estimate the internal consistency, test-retest reliability, discriminant and concurrent validity of the Modified Dental Anxiety Scale (MDAS).

METHOD

Survey of a cohort of 135 dental patients in three equal groups (non-anxious; treated anxious; highly anxious). The average age of the total sample was 39.2 years (SD = 13.21), 101 patients (75%) were female. All patients were asked to complete the MDAS, together with the brief form (six items) of the Speilberger Trait Anxiety Inventory (STAI). Thirty-three participants completed the MDAS on a second occasion 2-3 months after the first testing session.

FINDINGS

The MDAS is highly internally consistent (Cronbach alpha = 0.93) and shows good reliability over time (Intra-class correlation coefficient = 0.93). The MDAS was found to discriminate between the three groups of participants defined by self-reported anxiety level, and correlates highly with the Speilberger Trait Anxiety Inventory.

CONCLUSIONS

The MDAS is a highly consistent and reliable measure which has good discriminant and concurrent validity.

[Background data about the dental fear scores of Hungarian secondary school students]

Free association (coupling) of 139 Hungarian secondary school students (90 females, 49 males, age between 14-18 yr.) about their teeth was collected. Dental fear (DAS, DFS) and general anxiety scores were measured. Typical dental events (i.e.: simple and traumatising dental treatments, etc.) were coupled by the participants in 36,7% of the cases. Functions and importance of the teeth and oral hygiene were described in 7,2% of the cases. Simple, grotesque, or magical stories and tales about teeth were found in 16,5% of the cases. No answer was found in 39,6% of the cases. Highest dental fear and general anxiety scores were found in the group coupled traumatising dental treatment. Age had no influence on the sense of the association (coupling).

A randomized trial comparing alternative approaches to prenatal diagnosis counseling in advanced maternal age patients

Prenatal diagnosis (PND) is offered routinely as part of pregnancy care to a large number of women at increased risk of fetal anomalies. Despite an extraordinary growth in the use of PND and significant resource allocation, few studies have examined outcomes of PND counseling, and virtually no research has evaluated the relative efficacy of various approaches to genetic counseling. This study was a randomized trial that compared which counseling methods - individual, group, and use of a decision aid - are effective in PND counseling for women of advanced maternal age (>/=35 years) and their partners. Three hundred and fifty-two women and 225 partners completed pre- and post-intervention questionnaires assessing changes in knowledge, decisional conflict, state anxiety, satisfaction, use of PND, and pregnancy outcomes. All participants showed a significant increase in knowledge and a decrease in decisional conflict post intervention. Those in the group intervention showed a significantly greater increase in knowledge than those in the individual counseling intervention. While high levels of satisfaction were reported by all, those in individual counseling were significantly more satisfied than those receiving group counseling or the decision aid. This study has shown unique benefits with each type of intervention such that women and their partners preferred individual genetic counseling, while they learned best in group-counseling sessions, and experienced the least decisional conflict regarding genetic testing with a decision aid.

[Psychophysiological evaluations of clinical efficacy in outpatients: Morita therapy for psychophysiological insomnia]

The clinical efficacy of Morita therapy on outpatients with psychophysiological insomnia (PPI) was evaluated psychophysiologically. The subjects, 13 outpatients (mean age: 47. 6 +/-17.7, male/female: 6/7), were diagnosed with PPI at the International Classifications of Sleep Disorders. For each patient the examinations were performed consecutively during, one week of pre-treatment (PRE) and post-treatment (POST; 2.0 +/- 1.1 months), using objective (wrist actigraphy) and subjective (sleep log) measurements. The results were as follows. (1) Subjectively, total sleep time increased and sleep latency shortened significantly at POST compared with PRE. (2) Objectively, the numbers of times of waking decreased, sleep efficiency increased and mean activity in sleep decreased significantly at POST compared with PRE. (3) Dissociations between subjective and objective evaluations about awakening time, total sleep time and sleep latency at PRE improved significantly at POST. From the above-mentioned results, it was suggested that the lack of dissociations between subjective and objective evaluations at POST showed psychophysiologically the reconstruction of sleep a preventing association and breaking free from the entrapment of insomnia. This finding suggested that Morita therapy on outpatients with PPI was effective in helping subjects accept their insomnia and lied a constructive life.

Anxiety, Emotional Suppression, and Psychological Distress Before and After Breast Cancer Diagnosis

The authors examined the influence of anxiety and emotional suppression on psychological distress in 21 patients with breast cancer and 72 patients with benign breast tumor. The patients with breast cancer who suppressed emotion and had chronically high levels of anxiety felt higher levels of emotional distress both before and after the diagnosis. Such patients need psychological interventions, including encouragement to express and communicate their emotions, immediately after disclosure of the diagnosis to help maintain psychological adjustment in the face of the disease.

The relationship between hope and subjective well-being: Reliability and validity of the dispositional Hope Scale, Japanese version

We conducted three studies to translate the Snyder Hope Sales into Japanese, examine reliability and validity of the Japanese version, and investigate the relationship between the tendency to be hopeful and subjective well-being. In Study 1, confirmatory factor analysis was performed of the Hope Scale in the Japanese version: agency and pathways. Its test-retest reliability coefficients for the data from 113 undergraduates ranged from .81 to .84. In Study 2, concurrent validity of the Japanese version Hope Scale was examined with the data from 550 respondents, which looked at the correlations between hope and optimism, self-esteem, and self-efficacy. Results suggested that the Japanese version had high validity. In addition, the tendency to be hopeful had negative correlations with stress response, hopelessness, depressive tendency, and trait anxiety, and positive one with feeling of happiness. In Study 3, 175 undergraduates completed the Hope Scale and State-Trait Anxiety Inventory (STAI) immediately prior to final examinations. Results of regression analysis suggested that the tendency to be hopeful moderated examination anxiety. Taken together, results of the studies supported the hypothesis that hope had positive effects on subjective well-being.

Regular dental visits and dental anxiety in an adult dentate population

BACKGROUND

The objective of this study was to investigate factors associated with regular dental visits in an adult population.

METHODS

A representative sample of non-institutionalized dentate adults (aged 18 through 69 years) from the Detroit tricounty area (Wayne, Macomb and Oakland counties) was randomly selected using list-assisted random digit dialing. The authors collected the data through a self-administered questionnaire that asked for information about regular dental visits, private dental insurance, perceived oral health status and dental treatment experience. The authors used Corah's Dental Anxiety Scale to measure respondents' dental anxiety level. They also conducted a descriptive analysis and a logistic regression analysis.

RESULTS

A final sample of 630 adults who resided in 368 households participated in this study. Seventy-two percent of respondents had dental insurance (excluding Medicaid). About 63 percent reported that they visited a dentist regularly. About 12 percent of adults had high dental anxiety (a score of 13 or higher on the Corah scale). A logistic regression model found that dental anxiety, dental insurance status and perceived oral health status were significantly associated with regular dental visits after accounting for sociodemographic factors such as sex, age and income. Among those who had dental insurance, dentally anxious adults were significantly less likely to visit dentists regularly. However, this association was not significant among respondents without dental insurance.

CONCLUSION

Dental insurance, perceived oral health status and dental anxiety were associated with regular dental visits. Dental anxiety was an influencing factor in regular dental visit behavior, especially among adults who had private dental insurance.

CLINICAL IMPLICATIONS

Practitioners need to be educated about the causes of dental anxiety and receive training in how to treat the problem.

Defensive copers show a deficit in passive avoidance learning on Newman's go/no-go task: implications for self-deception and socialization

The present study investigated whether passive avoidance learning was retarded by defensive coping strategies designed to minimize exposure to negatively valenced stimuli. High-anxious individuals, low-anxious individuals, and defensive copers completed a computerized go/no-go task, in which they learned when to press or not to press a button, in response to contingent positive and negative feedback. The duration that feedback remained onscreen was self-regulated. Defensive copers showed preferential reflection away from negative feedback, committed more passive-avoidance errors, and were characterized by impaired learning, overall. Further, the ratio of reflection on negative feedback to reflection on positive feedback directly mediated both passive-avoidance errors and overall learning. Defensive coping strategies, therefore, appear to interfere with passive avoidance learning, thereby fostering perseverative, dysfunctional action patterns by reducing knowledge gained from previous mistakes. Implications for the learning of effective socialization strategies, and for psychopathy-which is commonly characterized by similar passive-avoidance deficits-are subsequently considered.

Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery

BACKGROUND

The primary aims were to compare the pain-relieving effect and post-operative well-being between electro-acupuncture analgesia (EA) and conventional analgesia (CA) comprising opiates. Further aims were to compare time for mobilization, and costs for time and drug consumption.

METHODS

In all, 160 women undergoing IVF were randomized, according to a computer-generated list, to EA or CA. Well-being was evaluated with the State Trait Anxiety Inventory (STAI). Pain and subjective expectations and experiences were recorded on a visual analogue scale (VAS). Time and drug consumption were recorded.

RESULTS

Although VAS pain ratings were significantly higher at oocyte aspiration (P < 0.0001) and after retrieval (P < 0.01) in the EA than in the CA group, they were similar 60 min after surgery. Both groups had similar STAI well-being scores. The EA group was significantly less tired and confused than the CA group after oocyte aspiration. No significant differences in time and costs for drug consumption were noted.

CONCLUSION

EA cannot generally be recommended as a pain-relieving method at oocyte aspiration but might be an alternative for women desiring a non-pharmacological method. An advantage of EA is less post-operative tiredness and confusion compared with CA.

A short-term follow-up of treatment outcome in groups of uncooperative child dental patients

AIM

To evaluate the short-term follow-up outcome in four subgroups of uncooperative child dental patients referred to a specialist paediatric dental clinic in Sweden.

METHODS

Seventy children, classified into four groups (based on fear, temperament, behaviour and verbal intelligence), were followed-up at their public dental clinics after termination of specialist dental treatment. Questionnaire assessments of children's dental and general fear, parental dental fear, emotional stress, locus of control and parenting efficacy were made by parents pre and post treatment and at follow-up and were analysed within and between groups. At follow-up, parents rated their children's coping and procedure stress, while treatment acceptance was rated by the dentists.

RESULTS

Decreases in child dental fear were maintained at follow-up, although a third of children still had moderate or high dental fear. For those children who had been classified into the externalising, impulsive group, an increased risk of non-acceptance (RR=3.7) was indicated. The risk of dental fear at follow-up was increased for the group of fearful, inhibited children (RR=3.8). For the study group as a whole a poorer follow-up outcome could be predicted by avoidance behaviour (OR 12.9-16.6) and moderate or high post treatment dental fear (OR 6.5- 21.3).

CONCLUSIONS

Fearful, inhibited child dental patients may need, due to dental fear, extra attention even after successful dental treatment at a specialist clinic. Externalising, impulsive children constitute a special challenge for dentistry. The continued need for adjusted management after termination of specialist treatment can be predicted from avoidance behaviour and post treatment dental fear scores.

Identified factors in child-dentist relationship important for the management of dental anxiety in Nigerian children

AIM

To investigate the effects and interrelationship between dental anxiety and dentist's experience, dentist's behaviour, type of treatment received and the behaviour of Nigerian children during treatment.

METHODS

Pre- and post-dental treatment anxiety levels of 69 child patients, who were attending the dental clinic to receive dental treatment for the first time, were assessed using the DFSS-SF. The dentist's and child's behaviour during treatment procedures were unobtrusively observed and recorded. The pre- treatment anxiety levels were classified as high (HAC) and low (LAC), while those of the dentists who managed the children were categorized as experience or inexperienced. The interrelationship between a child's dental anxiety level, dentist's behaviour during child management, dentist's experience and the type of treatment the child received were analysed.

RESULTS

The anxiety level of the children decreased significantly post-treatment when experienced dentists managed the child in comparison to inexperienced dentists (Z=3.22, p<0.02). The dentist's behaviour did not significantly affect the anxiety level of the child. However, physical contact was used more frequently with HAC than LAC (z=2.27;p<0.023). There was no association between a child's behaviour in the dental chair and their anxiety level (chi(2)=0.08, p<0.93). Also, the more invasive the procedure, the less the tendency for a noted decrease in anxiety level of a child post-treatment, though this was statistically insignificant (z=1.34; p<0.44).

CONCLUSION

The dentist's behaviour played no role in changing the anxiety level of a child nor did it have any influence on anxiety-related behaviour of a child. However, the experience of the dentist was a very significant factor for effecting a decrease in the dental anxiety level change for children.

Willingness to pay for dental fear treatment. Is supplying dental fear treatment socially beneficial?

The aim of this paper is to discuss the social desirability of supplying dental fear treatment in addition to dental treatment using the results from a treatment programme for patients with severe dental fear. The programme consisted of three different dental fear treatments: Cognitive therapy, applied relaxation and nitrous oxide sedation, in addition to dental treatment. To evaluate the effects of uncertainty on the patients' benefits from the programme, we elicited their willingness to pay, both before and after receiving treatment, since we expected patients to be uncertain about the outcome of the dental fear treatment. We found that the social desirability of the treatment was very sensitive to uncertainty. While only 24% of the patients were willing to pay the actual cost of the treatment before attending, 71% were willing to pay afterwards. This implies that many patients who would benefit from the treatment ex post are not willing to pay the cost of the treatment ex ante, and will thus not receive any treatment unless it is subsidized.

Anxiety and extraction of third molars in Turkish patients

Preoperative anxiety is widespread and adversely affects a patient's physical and psychological outcome. Extraction of third molars is common, and many patients complain of anxiety and emotional disturbance. We assessed the anxiety of patients in Turkey before extraction of third molars. A total of 120 patients were admitted for removal of one or more third molars under local anaesthesia. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Spielberger's State Trait Anxiety Inventory (STAI) were used to evaluate anxiety. The results showed that women were significantly more anxious than men; women who had not had a previous operation were more anxious than other women; there was no difference in the anxiety scores of patients who had previously had a local anaesthetic and those who had not; there were no differences in anxiety as measured by trait scores; patients who wanted a lot of information were more anxious.

Efficacy of the herbal medicine Unkei-to as an adjunctive treatment to hormone replacement therapy for postmenopausal women with depressive symptoms

OBJECTIVE

Although hormone replacement therapy (HRT) improves menopausal depressive symptoms, women unresponsive to HRT need an antidepressant drug as an effective adjunctive therapy. The aim of this study was to assess whether the herbal medicine Unkei-to has an impact on HRT-resistant menopausal depressive symptoms as an effective adjunctive therapy combined with HRT.

METHODS

Twenty-four HRT-resistant menopausal depressive women were randomly assigned to group 1 (n = 12) or group 2 (n = 12). Subjects in group 1 were accessioned into 6 months of open treatment with Unkei-to as an adjunctive therapy and changed to Toki-shakuyaku-san for 6 months following a 1-month washout period. Group 2 started with Toki-shakuyaku-san for 6 months and then changed to Unkei-to for 6 months following a 1-month washout period.

RESULTS

Three months' treatment with Unkei-to as an adjunctive therapy significantly improved Zung's Self-Rating Depression Scale (ZSDS) scores, State-Anxiety (STAI-1) scores, and Trait-Anxiety (STAI-2) scores noted before treatment, and this effect continued at 6 months. Treatment with Unkei-to was also significantly effective in reduction of ZSDS scores, STAI-1 scores, and STAI-2 scores at 3 months compared with Toki-shakuyaku-san treatment, and this effect continued at 6 months.

CONCLUSIONS

Unkei-to is another option as an adjunctive herbal therapy in HRT-resistant menopausal depressive women.

[Mammography-related pain and anxiety]

PURPOSE

To investigate whether informing patients about mammographic compression changed the anxiety and pain that they experience during mammography.

MATERIALS AND METHODS

Five hundred and one patients were enrolled in the study. Two hundred and fifty seven (51.3%) were informed before the procedure by written forms explaining the necessity of compression. The remaining 244 (48.7%) didn't get any pre-procedural information. All participants completed demographic form and Spielberger's State Anxiety Inventory while they were waiting for mammography. They marked the level of pain due to compression on a 100-mm visual analog scale (VAS) after the procedure. Chi square, Pearson's correlation and Student's t tests were used for statistical analyses.

RESULTS

We didn't find any significant difference between the anxiety scores of the informed (41.4+/-7.9) and uninformed (40.9+/-7.7) women, but the pain level was significantly lower in the informed group (16.5+/-22.4) than in the uninformed group (24.5+/-28.1). There was no statistically significant relationship between the anxiety and pain levels. Women who had recently felt tense and nervous or had a fear of breast cancer diagnosis had higher anxiety levels.

CONCLUSION

Our data shows that informing patients about examination decreases the level of pain due to mammographic compression, but does not alter the anxiety level. The main cause of anxiety appears to be the fear of a malignant diagnosis. Any intervention to decrease this fear may increase the compliance rates for screening mammography.

Kava treatment in patients with anxiety

In several clinical trials, mainly conducted with a dose of 300 mg kava extract per day, kava has been employed successfully for the treatment of anxiety disorders. The goal of the placebo-controlled double-blind outpatient trial was to obtain more information on the dosage range and efficacy of a kava special extract WS 1490 in patients with non-psychotic anxiety. 50 patients were treated with a daily dose of 3 x 50 mg WS 1490 during a 4-week treatment period followed by a 2-week safety observation phase. In the active treatment group, the total score of the Hamilton anxiety scale (primary efficacy variable), showed a therapeutically relevant reduction in anxiety versus placebo (more than 4 points). In the secondary variables studied, HAMA 'somatic and psychic anxiety' subscales, the Erlangen anxiety, tension and aggression scale (EAAS), the brief personality structure scale (KEPS), the adjective checklist (EWL 60-S) and clinical global impressions scale (CGI), a trend in favour of the active treatment was detectable. WS 1490 was well tolerated and showed a safety profile with no drug-related adverse events or post-study withdrawal symptoms. It can be concluded that the applied 150 mg WS 1490 per day is an effective and safe treatment of non-psychotic anxiety syndromes in the described population.

A pilot study evaluating anxiety and depressive scores in acne patients treated with isotretinoin

BACKGROUND

Isotretinoin therapy and its alleged adverse psychiatric effects have received considerable media attention during the past years. The aim of this pilot study was to investigate whether there was any association between isotretinoin therapy and anxiety, depression or suicidal ideation.

METHODS

Forty-five patients with severe recalcitrant acne were enrolled in this study. Isotretinoin was administered at a dose of 0.5-1 mg/kg per day in two divided doses with food for 16 weeks. All patients received a complete dermatological examination and the severity levels of their acne were scored according to the Leeds Revised Acne Grading system at baseline (before isotretinoin treatment) and follow-up assessments at weeks 4, 8 and 16 of the treatment. Severity of anxiety and depressive symptoms were assessed with the Clinical Anxiety Scale and Montgomery-Asberg Depression Rating Scale before and upon completion of the 16-week isotretinoin treatment.

RESULTS

Twenty-three patients completed the final assessment. There was a statistically significant decrease in anxiety scores. Depression scores also decreased but were not statistically significant. No patient committed or attempted suicide.

CONCLUSIONS

This pilot study was unable to detect an association between the use of isotretinoin and an increased risk for anxiety, depression, or suicidal thoughts.

Prediction of success and failure of behavior modification as treatment for dental anxiety

Behavior modification techniques are effective in the treatment of extreme dental anxiety, but their success is by no means absolute. In the present article, the Corah Dental Anxiety Scale (DAS), the self-report symptom inventory SCL-90R and a questionnaire accessing subjects' daydreaming styles (the Short Imaginal Process Inventory) were used to develop possible predictive measures for success and failure of behavior modification as a treatment for dental fear. The patients' level of distractibility and mind wandering, initial dental anxiety and somatization significantly predicted the success of therapy. The odds ratio indicated that the risk of therapy failure increased about 11 times with an increase of one scale of the Poor Attention Control Scale, about three times with an increase of one level of the mean DAS score, and 0.17 times with an increase of one level of somatization. The predictive value of the chosen scales was 80%. Thus, the use of these scales as part of an initial admittance process for patients who suffer from dental anxiety can enhance our ability to better recognize patients who are prone to fail behavior therapy as treatment for their problem, and enable their referral for other possible modes of treatment.

Does maternal serum screening for Down syndrome induce anxiety in younger mothers?

INTRODUCTION

To assess anxiety levels in mothers with low-risk pregnancies before and after offering routine serum screening.

METHODS

A prospective study was carried out at the Kandang Kerbau Women's and Children's Hospital in Singapore from February 2000 to August 2000. We used standard statistical analysis and Spielberger's state-trait anxiety inventory (STAI) which consists of 40 items to assess anxiety. Anxiety levels were assessed at several stages: before serum screening counselling, after counselling but before serum screening, before the routine 20-week obstetrical screening ultrasound scan, and after ultrasound scan results were acknowledged four to six weeks later. As the STAI questionnaire has only been validated for an English-speaking population, only English-speaking women were recruited for the study. The subjects included 111 women between 15 to 20 weeks gestation that were randomly selected (without any risk factors) for serum screening counselling.

RESULTS

Anxiety levels did not decline significantly after counselling by a trained nurse-counsellor. They were highest prior to counselling and were significantly higher compared to all other times in which anxiety was assessed. Anxiety levels were lowest after the serum screening and routine 20-week screening ultrasound scan results were acknowledged. They were also significantly lower compared to all other times in which anxiety was assessed.

CONCLUSION

Anxiety before serum screening was not abnormally high and routine serum screening offered by trained nurse counsellors did not significantly increase maternal anxiety in mothers with low risk pregnancies.

Trait anxiety and nicotine dependence in adolescents: a report from the DANDY study

The Revised Children's Manifest Anxiety Scale (RCMAS) and the Hooked on Nicotine Checklist (HONC) were used to measure trait anxiety and tobacco dependence in a population of 581 adolescents. Smokers demonstrated higher mean RCMAS scores (9.3, S.D.=6.5) than nonsmokers did (7.4, S.D.=6.2, t=-3.7, P<.001). Participants with symptoms of tobacco dependence had higher RCMAS scores (mean=11.6, S.D.=6.0, n=115) than did the participants without symptoms (mean=7.8, S.D.=6.0, n=177, t=-5.3, P<.001). Scores on the RCMAS and the HONC correlated positively (n=292, r=.32, P<.001). Participants who had felt relaxed in response to their first exposure to nicotine were also more likely to develop dependence and to report that stress caused cravings or a need to smoke. Trait anxiety and relaxation in response to the first dose of nicotine were unrelated and appear to be independent risk factors for the development of nicotine dependence and a reliance on tobacco to cope with stress.

Anxiety measurements in university students undergoing third molar extraction

OBJECTIVE

This investigation was conducted to quantitate the anxiety associated with third molar extraction in university students, and to compare the measured anxiety before and after extraction and between men and women, first and second extraction, and impacted versus nonimpacted tooth extraction.

STUDY DESIGN

The Japanese version of The State-Trait Anxiety Inventory (STAI), a psychological test, was given to 108 students undergoing third molar extraction. The students completed the test on the first examination (day 1), immediately before the extraction (day 2), and the day after the extraction (day 3).

RESULTS

The state anxiety (STAI-S) score showed no significant difference between days 1 and 2, but the score on day 3 was lower than that on day 1, with a decrease in cases with a stage IV or V. Women showed more anxiety state on day 2 than men. The anxiety score on days 2 and 3 for the second extraction were significantly lower than those for the first extraction in 43 students who underwent third molar extractions twice. The change in the trait anxiety (STAI-T) stage was unremarkable among days 1, 2, and 3. No statistical difference was found in the anxiety between students undergoing impacted and nonimpacted third molar extraction.

CONCLUSIONS

The anxiety status of students undergoing third molar extraction could be quantitatively evaluated using the STAI. The results of this investigation may provide oral maxillofacial surgeons with useful information about patients' anxiety throughout the tooth removal process.

Path model of psychological antecedents to pain experience: experimental and clinical findings

OBJECTIVES

Two studies are described addressing how anxiety, fear of pain, and catastrophizing impact on pain experience.

METHODS

In study 1, 66 undergraduates (34 men, 32 women) completed measures of state and trait anxiety, fear of pain, and catastrophizing prior to participating in a cold pressor procedure. In study 2, 60 undergraduates (30 men, 30 women) completed the same measures and participated in dental hygiene treatment and rated the pain they experienced during a scaling procedure (removing deposits from the tooth surface).

RESULTS

In both studies, fear of pain and catastrophizing were significantly correlated with pain intensity ratings, and fear of pain and catastrophizing were correlated with each other. Trait anxiety was correlated with catastrophizing but not with fear of pain or pain. Path analyses revealed significant paths from trait anxiety to state anxiety, from trait anxiety to catastrophizing, and from catastrophizing to pain intensity ratings.

DISCUSSION

The findings suggest that although fear of pain and catastrophizing are related constructs, catastrophizing provides unique predictive ability for pain ratings, while fear of pain does not. Clinical and theoretical implications of these findings are discussed.

The effect of pre-operative information in relieving anxiety in oral surgery patients

Appropriate stress management of patients is essential for smooth running of invasive or surgical dental procedures conducted under local anaesthesia.

OBJECTIVE

The current study analysed the effectiveness of pre-operative information provision for anxiety reduction during dentoalveolar surgery in patients with high- or low-trait anxiety.

METHODS

Patients scheduled for oral surgical procedures performed by six private dental practitioners were invited to participate in the study. They were randomly assigned to four groups and received the following pre-operative information: (i) basic information only, (ii) basic information with details of the operative procedures, (iii) basic information with details of the expected recovery, and (iv) basic information with details of both the operative procedures and recovery. The participants' trait anxiety level was measured with the Depression Anxiety Stress Scales (DASS), then they were divided into high- or low-trait anxiety groups with the method of median-split on the basis of the DASS score. Self-rated anxiety was recorded immediately before, during and 10 min after the surgical procedures.

RESULTS

High-trait anxiety subjects gave higher self-reported anxiety levels (repeated-measures ANOVA, P < 0.05). Pre-operative provision of details about the expected recovery only or details concerning both the operative procedures and recovery led to significant reduction in self-reported anxiety among the participants throughout the procedure (P < 0.01). However, information on operative procedures led to anxiety reduction in low (P < 0.05) but not high-trait anxiety participants.

CONCLUSION

Provision of pre-operative information of the recovery process leads to significant anxiety reduction in all patients who undergo surgical/invasive procedures with local anaesthesia.

[Psychological changes during rehabilitation for newly visually impaired people]

In study 1, the purpose was to examine the psychological changes during rehabilitation for newly visually impaired people. Before and after the 6 months rehabilitation training, we conducted Yatabe-Guilford Personality Inventory and Manifest Anxiety Scale (MAS). The results showed that scores of depression, cyclic tendencies, feeling of inferiority, nervousness, lack of objectivity, and anxiety decreased and ascendance increased significantly. In study 2, we compared the differeces of scores between those who needed psychotherapy in addition to rehabilitation training and those who didn't. People who needed psychotherapy scored significantly higher on the depression and lack of objectivity scales than those who didn't. Supportive and behavioral counseling was conducted, however no significant changes were observed before and after psychotherapy as a whole. Furthermore, the relations among the methods, purposes and effects of psychotherapy were not observal. As a conclusion, we need to develop methods of psychotherapy which accelerate the acceptance of disability and improve psychological adaptation sufficiently.