Biomedical subjects

A de Jongh

Publications and source records attributed to A de Jongh.

At least 37 records · Page 2Linked to original sources

PubMed2000

[Choking phobia: symptomatology, diagnosis and treatment].

Clinically significant forms of choking fear (i.e., choking phobia) are characterized by fear and avoidance of objects and situations that may lead to choking such as ingestion of food or pills. During dental treatment patients may also be confronted with situations that give rise to extreme fear of suffocating or being choked (mouth full of water, the making of dental radiographs and dental impressions). Choking phobia often develops following an episode of choking on food. The paper shortly reviews relevant literature, medical and psychiatric differential diagnosis, as well as possible treatment approaches to individuals suffering from choking fear.

Airway Obstruction↗

PubMed1999

Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables.

OBJECTIVE: To assess differences among highly anxious dental patients assigned to different treatment modes (i.e. behavioural management (BM), nitrous oxide sedation (NOS), intravenous sedation (IVS). Patients were compared with regard to psychological and dental variables before treatment (e.g. number of decayed teeth), and dental variables after treatment (e.g. number of fillings made). DESIGN: Dentists experienced in the treatment of highly anxious patients allocated patients to a treatment mode based upon their clinical judgement. SETTING: Centre for Special Dental Care, Amsterdam, The Netherlands. SUBJECTS: 211 patients from this dental fear clinic. MEASURES: General psychopathology, as measured by the Symptom Checklist 90 (SCL-90), and dental anxiety (DAS, S-DAI, 10-point scale) were measured prior to treatment. From the panoramic radiograph the following pre-treatment dental variables were assessed: number of teeth, number of decayed teeth, number of retained roots, and number of root-filled teeth. After treatment, number of fillings, extractions, endodontically treated elements, number of visits, and treatment duration, were determined from the patients' records. RESULTS: Of the 144 patients who received dental treatment at the clinic, 46.5% was treated using a BM approach, 27.8% with NOS, 22.9% with IVS, and 2.8% under GA. No differences among the treatment groups were found with regard to SCL-90 and dental anxiety. The results showed that patients in the IVS group had statistically significant more decayed teeth than patients in the BM group. Furthermore, more fillings were made in the IVS group than in the BM group. CONCLUSION: Since it appeared possible to treat a large proportion of patients by BM alone, training dentists in the application of psychological methods for the treatment of anxious patients should be stimulated. In addition, future research should seek for variables that, besides oral health, are better able to discriminate between groups of highly anxious patients than measures of dental anxiety and psychopathology.

Adolescent↗

PubMed1997

Psychological characteristics of patients applying for treatment in a dental fear clinic.

The aim of the present study was to assess psychological characteristics of highly anxious dental patients. Subjects were 321 patients (203 women) applying for treatment at a dental fear clinic in The Netherlands. Patients filled out several questionnaires to assess the amount of psychological complaints (Dutch version of the Symptom Checklist 90-Revised; SCL-90) and dental anxiety (Dental Anxiety Scale, Short version of the Dental Anxiety Inventory) approximately 4 months prior to their first appointment. The total mean score on the SCL-90 for the highly anxious patients was 142.7 (SD=47.2) for men and 166.5 (SD=64.3) for women. The SCL-90 total score and the mean scores of all subscales were significantly higher, and above the 80th percentile for most of the subscales, than the mean scores of the Dutch general population. The results indicate that patients who apply for treatment at a dental fear clinic are not just dentally anxious; they show complaints on a wide range of other psychological dimensions.

Adolescent↗

PubMed1997

[Beware of pitfalls. Problems in the somatization patient].

Somatization is a process that makes that psychological and social problems are experienced physically and presented as a physical complaint. This phenomenon should be considered as a potentially dangerous pitfall for the dentist. Not recognizing the underlying problems may lead of unnecessary and inadequate treatments. The purpose of this article is to provide the dentist with practical guidelines for proper assessment, treatment and referral of this patient category.

Dental Care↗

PubMed1997

[Mental problems in the dental practice: a compulsive disorder].

The aim of the present paper is to inform the reader about individuals who are suffering from severe mental disorders, such as obsessive-compulsive disorder (OCD). A case story enlightens the fact that anxiety disorders like OCD can have profound implications for the dental treatment plan.

Dental Anxiety↗

PubMed1996

[Treatment for dental anxiety. Evaluation of treatment of patients with anxiety].

This article presents the results of a study among 332 extremely anxious persons who applied for treatment at SBT, a Dutch special dental care clinic, between July 1990 and December 1991. It was found that 85% of these persons actually started treatment. Two and a half years later it appeared that 39% of them still received regular treatment, whereas 34% had completed treatment. Twelve percent stopped visiting before treatment was completed. Furthermore, results showed that dental anxiety was reduced after treatment. However, 36% of the patients still avoided appointments with a dentist. It is concluded that for most of the dentally anxious patients specialized care and oral health are no guarantee for regular dental attendance in the long term.

Adolescent↗

PubMed1995

Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.

This study investigated the psychometric properties of the Dental Cognitions Questionnaire (DCQ). This measure contains 38 items and assesses both frequency and believability of negative cognitions related to dental treatment. The results indicated that the DCQ has good internal consistency, high test-retest reliability, and satisfactory concurrent validity, as indicated by positive associations with indices of anxiety and other cognitive measures (n = 180). Factor analysis revealed a one factor solution. Furthermore, the DCQ discriminated strongly between dental phobics (n = 85) and non-phobic Ss (n = 70). Moreover, it was found that combinations of DCQ items have substantially more explanatory power than did a measure of dental trait anxiety, explaining up to 70.7% of the variance in state anxiety ratings in the dental situation. Overall, it appears that dental phobics have many extremely negative beliefs and self-statements about themselves and about what might happen during treatment. Since certain cognitions seem to play a critical role in fear evocation, diminishing catastrophizing ideation may be an important determinant of adjustment to dental treatment and reduction of psychological distress.

Adolescent↗

PubMed1995

Acquisition and maintenance of dental anxiety: the role of conditioning experiences and cognitive factors.

This study presents a contribution to the understanding of the mechanisms that are involved in the development and maintenance of dental anxiety. Subjects were 224 undergraduate psychology students who completed questionnaires regarding dental anxiety, painful and traumatic experiences, negative cognitions, dental beliefs, and how their attitude to dental treatment had changed during their life. The results showed that both the extent to which earlier dental treatments were perceived as painful and the extent to which these incidents were reported as traumatic were significantly related to dental anxiety. Evidence was also found to support the latent inhibition hypothesis, which predicts that patients less easily acquire dental anxiety in case they received a number of relatively painless treatments prior to conditioning. Both findings confirmed those earlier obtained by Davey in a conceptually similar design (Behaviour Research and Therapy, 27, 51-58, 1989). In addition, frequency of negative cognitions about dental treatment and dental anxiety appeared to be positively related (r = 0.74; P < 0.001). Significant differences were found between highly anxious Ss and Ss showing low levels of anxiety on a variety of expectations and beliefs related to undergoing dental treatment. The results are discussed in terms of a cognitive-behavioural perspective of dental anxiety.

Adolescent↗

PubMed1995

One-session cognitive treatment of dental phobia: preparing dental phobics for treatment by restructuring negative cognitions.

The purpose of this study was to investigate the effectiveness of a single session of cognitive restructuring in a sample of phobic dental patients. Fifty-two patients were randomly assigned to one of three conditions: cognitive restructuring (modification of negative cognitions), provision of information (about oral health and dental treatment), and a waiting list control condition. Both interventions maximally lasted one hour. In comparison with the waiting list control condition and the information intervention condition, the cognitive intervention condition not only showed a large decrease in frequency and believability of negative cognitions, but also exhibited a clear decline in dental trait anxiety. Analysis at a follow-up of one year demonstrated a further, drastic reduction in dental anxiety in both intervention conditions, wherein the difference among these conditions was not maintained. It is concluded that it is possible to obtain substantial reductions of dental trait anxiety through a single session of cognitive restructuring. Nevertheless, repeated exposure to the dental situation seems necessary for a further reduction of anxiety.

Adolescent↗

PubMed1995

Dutch students' dental anxiety and occurrence of thoughts related to treatment.

The present study was intended to explore the relationship between individuals' level of dental anxiety and thoughts (both self-statements and mental images) related to dental treatment. Subjects were 210 psychology students (75 males, 135 females). The results showed that 98% of the subjects reported one or more negative or catastrophic thoughts. A significant positive relationship was found between reported severity of anxiety (S-DAI scores) and frequency of thoughts. The results indicate that dental anxiety is associated with the tendency to experience negative or threatening thoughts concerning treatment.

Adolescent↗

PubMed1995

[A new development in the treatment of anxiety and trauma: "eye movement desensitization and reprocessing (EMDR)"].

This article presents a new development on the field of psychotherapy: Eye-Movement Desensitization and Reprocessing (EMDR). This recently developed procedure promises rapid and effective treatment of anxiety related complaints, including post-traumatic stress disorders (DSM-III-R). In essence the therapist induces a series of rapid and rhythmic eye-movements. EMDR facilitates cognitive changes and lasting decrease of anxiety. As indicated by research and illustrated by case histories, EMDR can be effective in one session. Until now there is no definitive explanation for the effectiveness of this method.

Adaptation, Psychological↗

PubMed1994

[Anxiety disorders in the dental practice. Part 2. Treatment of patients with anxiety].

The purpose of the present paper is to provide the dentist with a number of treatment steps that may reduce anxiety and may enhance trust, feelings of control and application of coping skills. A distinction should be made between patients with specific fear for one or more aspects of dental treatment and patients with non-specific, general anxiety. Practical implications for dental treatment of both groups are given. Dentists should be familiar with the signs and symptoms of the various anxiety disorders, in order to be able to properly refer or treat the patient.

Anxiety Disorders↗

PubMed1994

[Anxiety disorders in the dental practice. Part 1. Recognition of anxious patients].

The purpose of the present paper is to provide a summary of features of patients suffering from a wide range of anxiety disorders by means of case histories and clinical descriptions. Particularly, attention is being devoted to distinguishing between patients of which the predominant problem is specific fear for one or more aspects of dental treatment and patients with a non-specific or a general anxiety problem, including panic disorder and generalized anxiety disorder.

Anxiety Disorders↗

PubMed1994

[Amalgam. XII. Amalgam removed and patient cured?].

The aim of this article is to present a critical reflection on 'cures of patients' after the removal of dental amalgam fillings, reported in the popular press. It is concluded that, when the removal of dental amalgams in patients with a hypersensitivity to mercury is put aside, possible explanations for these questionable cures are not connected with the removal of amalgam but may involve the functioning of the immune system, the relation between environment and the opinions of patients and the influence of psychological factors on illness and health.

Attitude to Health↗

PubMed1993

Anxiety about dental hygienist treatment.

Although dental anxiety is a well investigated phenomenon in dental health care, remarkably little is known about anxiety reactions related to treatment carried out by the dental hygienist. In the present study anxiety reactions were measured among 101 patients attending the dental hygienist. General level of anxiety was assessed through the PAQ (Photo Anxiety Questionnaire; STOUTHARD, DE JONGH & HOOGSTRATEN, 1991), whereas an additional questionnaire was used to obtain information about specific stimuli and situations that might provoke anxiety in the dental hygienist situation. The results indicated that during dental hygienist treatment only 15% of the patients experienced no feelings of anxiety. Another 15% of the patients reported that a visit to the dental hygienist was more distressing than dental treatment. The level of anxiety appeared to be strongly related to a number of stimuli and situations, with actual pain (78%) and expected pain (67%) major anxiety provoking factors. The relation between pain and anxiety was highly significant, with highly anxious patients having more fear for pain than their low anxious counterparts. Also feelings and sounds of instruments, patient's helplessness and perceived lack of control over what happens were identified as important contributors to anxiety for the dental hygienist treatment. The results of this study suggests that treatment by the dental hygienist is a distressing event for many patients.

Adolescent↗

PubMed1993

What do anxious patients think? An exploratory investigation of anxious dental patients' thoughts.

According to BECK's cognitive model of emotional disorders (1976) anxiety is associated with negative and threatening thoughts concerning the likelihood of personal danger. In the present study the content of thoughts of 32 anxious dental patients was investigated. Patients' mean score for the Dental Anxiety Scale was 17.1 (SD = 2.0). The average time period patients had not visited a dentist was 9.1 yr (SD = 8.7). Using semi-structured interviews 132 thoughts were explored. The mean number of thoughts reported per patient was 4.1 (SD = 1.6). Almost all patients reported thoughts in some way related to their fear. All patients except one reported self-verbalizations of a negative or catastrophizing nature. Nine different categories of the content of the thoughts were identified. Nine percent of the thoughts consisted of visual images. The largest category (23%) consisted of catastrophic thoughts about the patient's own functioning during dental treatment, e.g., thoughts about losing control, panicking and dying. Fifty-nine percent of the patients reported thoughts of this type. The findings provide support for BECK's cognitive model of emotional disorders.

Adult↗

PubMed1992

[When the heart beats faster: negative expectations about dental treatment].

Many people expect dental treatment to be painful. This kind of expectation has important negative consequences for the patients' well-being. Disappointing occurrences during the treatment itself can further influence the expectations about a next treatment. The fact that the treatment result happens to be more positive than expected is a necessary instead of a sufficient condition for changing existing expectations. A cognitive model for dental fear is proposed and some implications for the general practice are discussed.

Dental Anxiety↗

PubMed1991

[Dental anxiety: the use of photographs].

A questionnaire on dental anxiety using photographs, the FAV, was constructed. It measures the expected level of dental anxiety at ten different moments with regard to the dental treatment. Answers are given on a scale consisting of five photographs of facial expressions, ranging from 'relaxed' to 'extremely anxious'. The FAV has good psychometric qualities. The validation results are promising.

Adolescent↗