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Cognitive vulnerability and dental fear.

Armfield JM, Slade GD, Spencer AJ - BMC Oral Health (2008)

Bottom Line: Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear.However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables.However, more extensive measures of vulnerability perceptions would be valuable in future investigations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, South Australia, Australia. jason.armfield@adelaide.edu.au

ABSTRACT

Background: The Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear. Although the model is applicable to all animal, natural environment and situational fears, it has not yet been applied specifically to dental fear. This study therefore aimed to examine the association between dental fear and perceptions of dental visits as uncontrollable, unpredictable and dangerous.

Methods: The study used a clustered, stratified national sample of Australians aged 15 years and over. All participants were asked in a telephone interview survey to indicate their level of dental fear. Participants who received an oral examination were subsequently provided with a self-complete questionnaire in which they rated their perceptions of uncontrollability, unpredictability and dangerousness associated with dental visiting.

Results: 3937 participants were recruited. Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear. In a logistic regression analysis, uncontrollability and dangerousness perceptions were significantly associated with high dental fear after controlling for age and sex. However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables.

Conclusion: Results are mostly consistent with the Cognitive Vulnerability Model of the etiology of fear, with perceptions of uncontrollability, unpredictability and dangerousness each showing a strong bivariate relationship with high dental fear prevalence. However, more extensive measures of vulnerability perceptions would be valuable in future investigations.

No MeSH data available.


Related in: MedlinePlus

Cognitive Vulnerability Model of the elicitation of a fear response to dental stimuli.
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Figure 1: Cognitive Vulnerability Model of the elicitation of a fear response to dental stimuli.

Mentions: A summary of the Cognitive Vulnerability Model as it relates to the elicitation of dental fear is provided in Figure 1. In line with the model, encountering a dental stimulus or situation invokes a rapid and pre-conscious automatic affective reaction which primes a susceptible individual for a flight or fight response. Simultaneously, a person's vulnerability schema is activated and this feeds into a slower and more cognitive general evaluation of the significance of the situation to the person. The general evaluation is also influenced by other cognitive factors such as coping mechanisms and attentional biases. Both the automatic affective reaction to the dental situation and the general evaluation give rise to a suite of physiological, behavioural and cognitive/emotional responses in a fearful person, which may include nervousness, panic, sweating, a strong desire to leave the situation, catastrophic thoughts, worry, panic etc. The dental visiting experience, as well as the associated perceptions and emotions, feed back into the vulnerability schema, affecting continued exposure to the fear-relevant stimulus and determining future reactions to visiting the dentist.


Cognitive vulnerability and dental fear.

Armfield JM, Slade GD, Spencer AJ - BMC Oral Health (2008)

Cognitive Vulnerability Model of the elicitation of a fear response to dental stimuli.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2266729&req=5

Figure 1: Cognitive Vulnerability Model of the elicitation of a fear response to dental stimuli.
Mentions: A summary of the Cognitive Vulnerability Model as it relates to the elicitation of dental fear is provided in Figure 1. In line with the model, encountering a dental stimulus or situation invokes a rapid and pre-conscious automatic affective reaction which primes a susceptible individual for a flight or fight response. Simultaneously, a person's vulnerability schema is activated and this feeds into a slower and more cognitive general evaluation of the significance of the situation to the person. The general evaluation is also influenced by other cognitive factors such as coping mechanisms and attentional biases. Both the automatic affective reaction to the dental situation and the general evaluation give rise to a suite of physiological, behavioural and cognitive/emotional responses in a fearful person, which may include nervousness, panic, sweating, a strong desire to leave the situation, catastrophic thoughts, worry, panic etc. The dental visiting experience, as well as the associated perceptions and emotions, feed back into the vulnerability schema, affecting continued exposure to the fear-relevant stimulus and determining future reactions to visiting the dentist.

Bottom Line: Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear.However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables.However, more extensive measures of vulnerability perceptions would be valuable in future investigations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, South Australia, Australia. jason.armfield@adelaide.edu.au

ABSTRACT

Background: The Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear. Although the model is applicable to all animal, natural environment and situational fears, it has not yet been applied specifically to dental fear. This study therefore aimed to examine the association between dental fear and perceptions of dental visits as uncontrollable, unpredictable and dangerous.

Methods: The study used a clustered, stratified national sample of Australians aged 15 years and over. All participants were asked in a telephone interview survey to indicate their level of dental fear. Participants who received an oral examination were subsequently provided with a self-complete questionnaire in which they rated their perceptions of uncontrollability, unpredictability and dangerousness associated with dental visiting.

Results: 3937 participants were recruited. Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear. In a logistic regression analysis, uncontrollability and dangerousness perceptions were significantly associated with high dental fear after controlling for age and sex. However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables.

Conclusion: Results are mostly consistent with the Cognitive Vulnerability Model of the etiology of fear, with perceptions of uncontrollability, unpredictability and dangerousness each showing a strong bivariate relationship with high dental fear prevalence. However, more extensive measures of vulnerability perceptions would be valuable in future investigations.

No MeSH data available.


Related in: MedlinePlus