A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Procedures and Participants
2.2. Measures
2.2.1. Cognitive Vulnerability to Dental Anxiety
2.2.2. Dental Anxiety
2.2.3. Traumatic Dental Experiences
2.2.4. Trait Anxiety
2.2.5. DFMQ Translation
2.2.6. Statistical Analyses
3. Results
3.1. Confirmatory Factor Analysis (CFA)
3.2. Predictive, Convergent, Construct, and Discriminant Validity
3.3. Associations of DFMQ Subscales with Dental Anxiety
3.4. Differences Based on Gender and Age between DFMQ Dimensions
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
1 | 2 | 3 | 4 | 5 | ||||
Fortemente in disaccordo | In disaccordo | Né d’accordo né in disaccordo | D’accordo | Fortemente d’accordo | ||||
1. Non sento di avere il controllo quando sono sulla poltrona del dentista | 1 | 2 | 3 | 4 | 5 | |||
2. Non sento di poter dire al dentista di fermarsi se sono agitato/a | 1 | 2 | 3 | 4 | 5 | |||
3. Mi sento impotente quando sono sulla poltrona del dentista | 1 | 2 | 3 | 4 | 5 | |||
4. Sento che il dentista farà ciò che vuole senza preoccuparsi di ciò che dico io | 1 | 2 | 3 | 4 | 5 | |||
5. Non sento di potermi fermare per riposare durante il trattamento se ne sento la necessità | 1 | 2 | 3 | 4 | 5 | |||
6. Mi sento come intrappolato/a sulla poltrona del dentista | 1 | 2 | 3 | 4 | 5 | |||
7. Non sento di poter essere coinvolto/a nel decidere quale trattamento vorrei mi fosse fatto | 1 | 2 | 3 | 4 | 5 | |||
8. Mi sento vulnerabile quando sono sdraiato/a sulla poltrona del dentista | 1 | 2 | 3 | 4 | 5 | |||
9. Quando sono sulla poltrona del dentista sento di non sapere cosa succederà dopo | 1 | 2 | 3 | 4 | 5 | |||
10. Sento di non conoscere l’intensità del dolore che potrei provare durante il trattamento | 1 | 2 | 3 | 4 | 5 | |||
11. Sento di non sapere cosa il dentista farà (ad es., iniezione, uso del trapano) mentre mi sottopongo a procedure odontoiatriche (ad es., devitalizzazione) | 1 | 2 | 3 | 4 | 5 | |||
12. Sento di non sapere quale strumento odontoiatrico sceglierà il dentista e a cosa servirà | 1 | 2 | 3 | 4 | 5 | |||
13. Sento di non sapere se avrò dolore dopo il trattamento | 1 | 2 | 3 | 4 | 5 | |||
14. Sento di non sapere se avrò qualche complicanza dopo il trattamento | 1 | 2 | 3 | 4 | 5 | |||
15. Sento di non sapere se perderò qualche dente durante il trattamento | 1 | 2 | 3 | 4 | 5 | |||
16. Sento di non sapere cosa sta succedendo nella mia bocca | 1 | 2 | 3 | 4 | 5 | |||
17. Credo che potrei essere ferito/a quando sono sulla poltrona del dentista | 1 | 2 | 3 | 4 | 5 | |||
18. Credo di poter sentire dolore quando vado dal dentista | 1 | 2 | 3 | 4 | 5 | |||
19. Credo di poter avere delle complicanze (infezioni, sanguinamento eccessivo) dopo e durante le procedure odontoiatriche | 1 | 2 | 3 | 4 | 5 | |||
20. Credo che al dentista possa cadere dalle mani il trapano. | 1 | 2 | 3 | 4 | 5 | |||
21. Credo che il dentista possa effettuare dei trattamenti non necessari | 1 | 2 | 3 | 4 | 5 | |||
22. Ho paura che l’anestesia non faccia effetto. | 1 | 2 | 3 | 4 | 5 | |||
23. Credo di poter soffocare durante il trattamento odontoiatrico | 1 | 2 | 3 | 4 | 5 | |||
24. Credo che gli strumenti usati possano rimanere bloccati in bocca | 1 | 2 | 3 | 4 | 5 | |||
25. Trovo sgradevole l’odore dello studio dentistico | 1 | 2 | 3 | 4 | 5 | |||
26. Credo di poter essere a rischio di contrarre infezioni. | 1 | 2 | 3 | 4 | 5 | |||
27. Trovo sgradevole il sapore e/o l’odore delle medicazioni usate durante le procedure odontoiatriche | 1 | 2 | 3 | 4 | 5 | |||
28. Trovo sgradevole sputare sangue e/o saliva | 1 | 2 | 3 | 4 | 5 | |||
29. Trovo sgradevole l’odore e/o il sapore del sangue | 1 | 2 | 3 | 4 | 5 | |||
30. Trovo sgradevole avere le mani del dentista in bocca. | 1 | 2 | 3 | 4 | 5 | |||
31. Trovo sgradevole l’odore e/o il sapore dello smalto del dente bruciato dal trapano. | 1 | 2 | 3 | 4 | 5 | |||
32. Trovo sgradevole l’acqua nebulizzata in bocca | 1 | 2 | 3 | 4 | 5 |
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Scale | Alpha | Range | Total Score: M (SD) |
---|---|---|---|
Disgust | 0.90 | 1–5 | 2.72 (0.95) |
Item | Std. Factor Loading (SE) | ||
DFMQ 25 | 0.80 (0.97) | ||
DFMQ 27 | 0.77 (0.07) | ||
DFMQ 28 | 0.67 (0.07) | ||
DFMQ 29 | 0.70 (0.07) | ||
DFMQ 30 | 0.78 (0.08) | ||
DFMQ 31 | 0.74 (0.08) | ||
DFMQ 32 | 0.74 (0.08) | ||
Unpredictability | 0.92 | 1–5 | 2.96 (1.09) |
Item | Std. Factor Loading (SE) | ||
DFMQ 9 | 0.82 (0.07) | ||
DFMQ 10 | 0.75 (0.07) | ||
DFMQ 11 | 0.83 (0.08) | ||
DFMQ 12 | 0.70 (0.08) | ||
DFMQ 13 | 0.73 (0.07) | ||
DFMQ 14 | 0.61 (0.09) | ||
DFMQ 16 | 0.80 (0.07) | ||
Uncontrollability | 0.91 | 1–5 | 2.52 (0.99) |
Item | Std. Factor Loading (SE) | ||
DFMQ 2 | 0.74 (0.08) | ||
DFMQ 3 | 0.76 (0.08) | ||
DFMQ 4 | 0.74 (0.08) | ||
DFMQ 5 | 0.74 (0.07) | ||
DFMQ 6 | 0.82 (0.07) | ||
DFMQ 7 | 0.84 (0.06) | ||
DFMQ 8 | 0.77 (0.08) | ||
Specific dangerousness | 0.89 | 1–5 | 2.46 (0.93) |
Item | Std. Factor Loading (SE) | ||
DFMQ 19 | 0.59 (0.07) | ||
DFMQ 20 | 0.73 (0.07) | ||
DFMQ 21 | 0.81 (0.07) | ||
DFMQ 22 | 0.66 (0.08) | ||
DFMQ 23 | 0.84 (0.07) | ||
DFMQ 24 | 0.82 (0.06) | ||
DFMQ 26 | 0.74 (0.07) | ||
General dangerousness | 0.71 | 1–5 | 2.79 (1.02) |
Item | Std. Factor Loading (SE) | ||
DFMQ 17 | 0.77 (0.08) | ||
DFMQ 18 | 0.58 (0.08) |
Scales | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
---|---|---|---|---|---|---|---|---|
1. Disgust | 1.00 | |||||||
2. Unpredictability | 0.62 *** | 1.00 | ||||||
3. Uncontrollability | 0.67 *** | 0.67 *** | 1.00 | |||||
4. Specific dangerousness | 0.76 *** | 0.65 *** | 0.75 *** | 1.00 | ||||
5. General dangerousness | 0.60 *** | 0.67 *** | 0.63 *** | 0.67 *** | 1.00 | |||
6. MDAS | 0.45 *** | 0.50 *** | 0.52 *** | 0.44 *** | 0.41 *** | 1.00 | ||
7. TDE | 0.15 * | 0.24 ** | 0.12 * | 0.14 * | 0.17 * | 0.32 *** | 1.00 | |
8. PEDA-SF | 0.43 *** | 0.45 *** | 0.49 *** | 0.47 *** | 0.41 *** | 0.74 *** | 0.30 *** | 1.00 |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
OR (95%CI) | p | OR (95%CI) | p | |
Disgust | 2.87 (1.85, 4.45) | <0.001 | 1.79 (0.93, 3.47) | 0.083 |
Unpredictability | 3.23 (2.03, 5.13) | <0.001 | 1.92 (1.08, 3.42) | 0.026 |
Uncontrollability | 2.98 (1.96, 4.53) | <0.001 | 1.90 (1.03, 3.51) | 0.039 |
Specific dangerousness | 2.26 (1.53, 3.35) | <0.001 | 0.62 (0.31, 1.24) | 0.174 |
General dangerousness | 2.33 (1.58, 3.41) | <0.001 | 1.09 (0.63, 1.88) | 0.753 |
Men (n = 90) | Women (n = 110) | |||||
---|---|---|---|---|---|---|
M (SD) | M (SD) | t | p | 95% CI | d | |
Disgust | 2.63 (0.93) | 2.79 (0.96) | −1.20 | 0.233 | −0.43, 0.10 | 0.17 |
Unpredictability | 2.74 (1.02) | 3.14 (1.12) | −2.61 | 0.010 | −0.70, −0.09 | 0.37 |
Uncontrollability | 2.37 (0.94) | 2.64 (1.03) | −1.95 | 0.048 | −0.55, 0.01 | 0.27 |
Specific dangerousness | 2.38 (0.90) | 2.51 (0.95) | −0.99 | 0.324 | −0.39, 0.13 | 0.14 |
General dangerousness | 2.64 (1.01) | 2.92 (1.03) | −1.99 | 0.047 | −0.57, −0.01 | 0.27 |
N | M (SD) | 95% CI | F | p | |
---|---|---|---|---|---|
Disgust | |||||
18–30 years | 43 | 2.42 (0.89) | 2.15, 2.71 | 2.56 | 0.057 |
31–45 years | 24 | 2.60 (0.84) | 2.25, 2.95 | ||
46–60 years | 51 | 2.93 (0.94) | 2.67, 3.20 | ||
61+ years | 82 | 2.78 (0.98) | 2.56, 2.99 | ||
Unpredictability | |||||
18–30 years | 43 | 2.53 (0.86) | 2.26, 2.79 | 3.12 | 0.027 |
31–45 years | 24 | 2.94 (1.02) | 2.51, 3.38 | ||
46–60 years | 51 | 3.13 (1.11) | 2.82, 3.44 | ||
61+ years | 82 | 3.09 (1.17) | 2.83, 3.35 | ||
Uncontrollability | |||||
18–30 years | 43 | 2.04 (0.83) | 1.78, 2.29 | 4.47 | 0.005 |
31–45 years | 24 | 2.56 (0.76) | 2.24, 2.89 | ||
46–60 years | 51 | 2.68 (1.15) | 2.36, 3.01 | ||
61+ years | 82 | 2.65 (0.98) | 2.43, 2.87 | ||
Specific dangerousness | |||||
18–30 years | 43 | 2.11 (0.88) | 1.84, 2.38 | 2.65 | 0.049 |
31–45 years | 24 | 2.52 (0.77) | 2.19, 2.84 | ||
46–60 years | 51 | 2.49 (0.96) | 2.22, 2.76 | ||
61+ years | 82 | 2.59 (0.94) | 2.39, 2.80 | ||
General dangerousness | |||||
18–30 years | 43 | 2.56 (0.95) | 2.26, 2.85 | 1.23 | 0.299 |
31–45 years | 24 | 2.89 (1.03) | 2.46, 3.33 | ||
46–60 years | 51 | 2.76 (1.15) | 2.44, 3.09 | ||
61+ years | 82 | 2.92 (0.97) | 2,70, 3.13 |
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Share and Cite
Gasparro, R.; Di Spirito, F.; Cangiano, M.; De Benedictis, A.; Sammartino, P.; Sammartino, G.; Bochicchio, V.; Maldonato, N.M.; Scandurra, C. A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ). Int. J. Environ. Res. Public Health 2023, 20, 2298. https://doi.org/10.3390/ijerph20032298
Gasparro R, Di Spirito F, Cangiano M, De Benedictis A, Sammartino P, Sammartino G, Bochicchio V, Maldonato NM, Scandurra C. A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ). International Journal of Environmental Research and Public Health. 2023; 20(3):2298. https://doi.org/10.3390/ijerph20032298
Chicago/Turabian StyleGasparro, Roberta, Federica Di Spirito, Mario Cangiano, Arianna De Benedictis, Pasquale Sammartino, Gilberto Sammartino, Vincenzo Bochicchio, Nelson Mauro Maldonato, and Cristiano Scandurra. 2023. "A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ)" International Journal of Environmental Research and Public Health 20, no. 3: 2298. https://doi.org/10.3390/ijerph20032298