Individualized Assessment and Treatment Program for TMD: Coping as a Mechanism
UConn Health
Summary
Temporomandibular/orofacial pain disorders (TMD) are a group of painful conditions with multiple determinants.This proposal has two main goals: 1) to test a highly individualized, adaptive treatment for TMD that has potential to be more effective than other psychosocial treatments; and 2) to discover the mechanisms by which psychosocial treatments work in chronic pain. TMD patients (N=160) will be randomized to receive standard care (STD) + an individualized assessment and treatment program (IATP) or to standard care + conventional cognitive-behavioral treatment (STD+CBT). It is expected that the STD+IATP treatment will yield lower pain, depression and interference scores over time than STD+CBT, and that changes in coping ability will mediate the treatment effects on outcomes.
Description
Temporomandibular/orofacial pain disorders (TMD) are a group of painful conditions with multiple determinants. A number of psychosocial treatments for TMD have been developed, but overall effectiveness has been limited, and the mechanisms of treatment are unknown. This proposal has two main goals: 1) to test a highly individualized, adaptive treatment for TMD that has potential to be more effective than other psychosocial treatments; and 2) to discover the mechanisms by which psychosocial treatments work in chronic pain. Patients with TMD-related pain of at least 3 months duration (N=160) will…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Age \> 18 years 2. Jaw pain \> 3 mo; \> 3/10 on pain scale 3. Positive Axis I diagnosis on the Diagnostic Criteria for temporomandibular disorders (DC/TMD), with or without disc displacement 4. Positive on \> 1 of: 1. Any myalgia diagnosis 2. Any myofascial diagnosis 3. Arthralgia 4. TMD-related Headache Exclusion Criteria: 1. Lack of fluency in English 2. Previous invasive surgery for TMD, not including arthrography or arthrocentesis 3. Extensive anatomical destruction or deterioration of the TM joint 4. Diagnosed as having pain of neuropathic or odontog…
Interventions
- BehavioralCognitive-Behavioral Treatment
Cognitive-behavioral coping skills training
- BehavioralIndividualized Assessment and Treatment Program
Experience-sampling based cognitive behavioral coping skills assessment and training
- OtherStandard Conservative Care
Standard conservative dental care for orofacial pain
Location
- UConn HealthFarmington, Connecticut