Search PubMed⌕ Search

Biomedical subjects

J J Marbach

Publications and source records attributed to J J Marbach.

At least 55 records · Page 3Linked to original sources
PubMed1990

Losing face: sources of stigma as perceived by chronic facial pain patients.

The purpose of this paper is to identify potential sources of estrangement and feeling psychologically flawed as perceived by temporomandibular pain and dysfunction syndrome (TMPDS) patients. It is our hypothesis that a primary source of patients' perceived stigma results from pejorative labeling by clinicians. The data come from a study of 151 women TMPDS patients. The results show that the lack of a known etiology or pathogenesis for the condition allows the possibility of pejorative labeling by influential others such as physicians and dentists that in turn causes TMPDS sufferers to feel stigmatized. Stigmatization is not the result of clinical factors per se or personality problems. Perceived stigma associated with TMPDS leads to the same sorts of strained interactions and feeling estranged that have been shown to be typical of people with other stigmatized conditions. These strains and feelings in turn may contribute to ill health.

Adaptation, Psychological↗
PubMed1990

Facial pain, distress, and immune function.

Chronic facial pain syndromes are associated with high levels of distress and depression. Immune system measures were investigated in otherwise healthy patients suffering from chronic temporomandibular pain and dysfunction syndrome (TMPDS) and in matched controls. No mean differences were found between TMPDS patients and the controls on any of the immune measures; however, both ConA and PWM responses in TMPDS patients were decreased in relation to the level of demoralization (P less than 0.05). Cognitive symptoms such as low self-esteem and perceptions of helplessness/hopelessness were implicated in these effects. In addition, among patients pain severity was independently associated with decreased ConA response (P less than 0.05). The data suggest possible correlates of stress-induced changes in the immune system.

Adult↗
PubMed1990

Coping and adaptation to facial pain in contrast to other stressful life events.

This article investigates whether coping with chronic pain influences adaptation to other negative life events using data on Temporomandibular Pain and Dysfunction Syndrome (TMPDS) patients (N = 99) and nonpatient controls (N = 98). It is found that cases cope very differently with pain than with other stressful events and that cases and controls do not differ on coping with nonpain events, with 2 exceptions. Cases view nonfateful events as more outside their control and they have more negative changes in usual activities following negative events. This excess of negative change is associated with greater demoralization and physical exhaustion. It is concluded that coping with repeated pain episodes leaves cases vulnerable to stressful events. Alternative interpretations, especially those involving the role of preexisting personality differences, are discussed.

Adaptation, Psychological↗
PubMed1990

The validity of tooth grinding measures: etiology of pain dysfunction syndrome revisited.

The current study explores the proposition that a treating clinician's etiologic model influences patients' reports of tooth grinding, the validity of, and subsequent research findings relying on these measures. The investigation compares self-reports of tooth grinding and related clinical variables for 151 cases of temporomandibular pain and dysfunction syndrome (TMPDS) treated by a clinician who does not explicitly support the grinding theory of the etiology of TMPDS, and 139 healthy controls. Cases were no more likely than well controls to report ever-grinding, but were actually significantly less likely than well controls to report current grinding. They were also significantly more likely to report that a dentist had told them they ground. Findings suggest that studies using self-report, clinician-report of tooth grinding (or both) are methodologically inadequate for addressing the relationship between tooth grinding and TMPDS.

Adult↗
PubMed1990

Current concepts in the management of pain in the head and neck cancer patient.

The question arises as to the role of the dentist in the management of patients whose pain is of malignant disease origin. Dentists called on to provide treatment to these patients will often be asked their opinions on pain management. The purpose of this article is to familiarize the dentist with current trends in the treatment of pain of malignant origins.

Acute Disease↗
PubMed1985

Psychosocial factors for failure to adapt to dental prostheses.

Currently, the best approach to the care and treatment of the patient with phantom bite lies in the dentist's familiarity with the signs and symptoms of these syndromes. This is especially important for those dentists interested in the practice of prosthetic dentistry. The patient with phantom bite presents problems for which there are no conventional solutions. This situation is not an isolated phenomenon for dentistry. Rapid and major advances in dental technology and public health programs during the last few decades have radically changed the character of the patient population. Interventions have become more effective and thus more contributive to a larger chronic dental population. Fewer persons lose their teeth. Palliation has become an alternative to the edentate state. Prolongation of the dentition has created need for the more complex treatments. These resulting interventions have also increased the number of organic, psychogenic, sociogenic, and iatrogenic complaints. Many of these complaints are not curable but nor are they terminal with regard to the dentition. For these chronic patient groups, dentistry has become an illness maintenance system. Thus, treatment intervention must begin to be viewed within the context of the ever-increasing complexity of technologic advances. In many cases, prolonged dental intervention and palliation result in the emergence of symptoms secondary to treatment. These secondary symptoms or "side effects" are sometimes more destructive than the disease the treatment was intended to palliate. Treatment, although frequently helpful, can, under certain circumstances, harm the patient. Phantom bite may be a metaphor for such a circumstance, as virtually all treatments promote the illness. Nowhere in the practice of dentistry is the advice of Szasz more relevant: "Don't just do something, stand there!"

Adaptation, Psychological↗
PubMed1984

Predictors of treatment outcome in patients with myofascial pain-dysfunction syndrome and organic temporomandibular joint disorders.

A total of 46 variables were initially examined for their usefulness as predictors of treatment outcome in patients with facial pain diagnosed as either MPDS or an organic disorder, such as disease of the TMJ (for example, degenerative joint disease or inflammatory arthritis) or typical facial neuralgia. The information about each variable was collected from the patients prior to beginning of treatment. Data included sociocultural background, social group attitudes, sociomedical orientation, level of psychologic distress, symptoms and treatment history, behavioral and attitudinal responses to pain, and clinical findings. Two discriminant analyses were performed to determine the most important variables for predicting whether a patient would respond successfully (with either elimination of or significant decrease in pain) or unsuccessfully (no change or increase in pain) to conservative reversible treatment. The first analysis was used to reduce the original group of 46 variables to 18 variables, which were labelled "potential" predictors. In the first analysis it was noted that clinical factors, such as oral status and physical examination findings, were irrelevant for predicting treatment outcome. Of the 16 clinical variables initially included for analysis, only the presence of clenching was included as a potential predictor. Patients' psychologic status, as measured by their level of psychologic distress, was also not relevant. The greatest number of potential predictors was related to patients' sociocultural background, sociomedical orientation, symptom and treatment history, and behavior in response to and attitudes toward pain. These factors, then, appear to be more useful than clinical and physical data as indicators of the potential response of facial pain patients with either MPDS or organic TMJ deficits to treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗
PubMed1984

Ethnicity and the pain experience.

The first objective of this investigation was to examine interethnic differences and similarities in the reported pain experience of Black, Irish, Italian, Jewish and Puerto Rican facial pain patients. Responses, attitudes and descriptions were found to be relatively similar after controlling for most variables shown by previous studies to influence reported pain experience. These variables include symptom history, signs elicited on physical, radiographic and laboratory examination, as well as social, cultural and psychological data. A thirty-five item scale was employed to measure patients' pain experience. Using analysis of variance and covariance, no significant interethnic differences were found for twenty-three (65.7%) of the items. The majority of the twelve items for which interethnic differences were found concerned the patients' emotionality (stoicism vs expressiveness) in response to pain, and interference in daily functioning attributed to pain. The pain experiences reported by the Black, Italian and Jewish patients were found most similar as measured by the twelve items. Irish and Puerto Rican patients appeared relatively distinct from the other groups as well as from each other. The second objective of this study was to identify particular variables that influence intraethnic variation in the pain experience. These were determined by multiple regression analysis of two summary indices previously derived by factor analysis of the thirty-five items. The specific variables which were most influential differed according to ethnicity, as follows: degree of medical acculturation for Black patients; degree of social assimilation for Irish patients; duration of pain for Italian patients; and level of psychological distress for Jewish and Puerto Rican patients. Thus, it appears that, in our study population, interethnic homogeneity is present for most aspects of the pain experience, while intraethnic heterogeneity exists for factors that may influence that experience. That is, the five ethnic groups were generally found to be similar in their reported responses to pain. Yet, each group was quite different with regard to factors which influence the responses.

Black or African American↗
PubMed1983

Illness behavior, depression and anhedonia in myofascial face and back pain patients.

Levels of depression, anhedonia, and illness behavior, as well as clinical and demographic variables, were measured in two groups of patients with chronic pain, one with facial, the other with back pain. For the total sample, significant correlations (p less than 0.01) were found between illness behavior and pain estimate (r = 0.30), anhedonia and depression (r = 0.33), and pain estimate and pain duration (r = 0.31). Facial pain patients showed illness behavior most strongly related to estimate of pain severity (r = 0.62); back pain patients showed illness behavior significantly related to depression (r = 0.59). Results also show that the physical site of pain relates to illness behavior but not mood of chronic pain patients.

Adaptation, Psychological↗
PubMed1982

Treatment of patients with temporomandibular joint and other facial pain by otolaryngologists.

By virtue of referral patterns, the otolaryngologist is in a position to be of considerable influence in the treatment of numerous patients with facial pain. In a facial pain clinic, the 525 consecutive patients seen could be classified into groups: myofascial pain dysfunction syndrome (52.9%); degenerative arthritis of the temporomandibular joints (16.6%); trigeminal neuralgia (15.3%); and a variety of other pain syndromes (15.2%). The most frequent types of health professionals contacted were, in decreasing order, dentists, general medical practitioners, otolaryngologists, and neurologists. The greatest number of consultations with all physicians resulted in either no treatment or referral. This was most common among otolaryngologists, and least among dentists and neurologists. Specific treatment, when provided, varied by specialty.

Dental Occlusion, Balanced↗