Astrid Heiberg

A follow-up study of a group of female patients with myofascial pain-dysfunction syndrome

The report is a follow-up study of 108 female patients with myofascial pain-dysfunction (MPD) syndrome who had previously been examined by a multiprofessional team consisting of a dentist, a psychiatrist and physiotherapists. After 1 1/2 year the patients were interviewed concerning possible improvement, present symptoms and perceived gain from the treatment. It was hypothesized that patients with a severely disturbed capacity for interpersonal contact would be the least likely to gain from treatment, regardless of type. This hypothesis as confirmed by the present findings. In addition, another subgroup of patients with apparently good capacity for interpersonal contact also tended to report lack of improvement. These were characterized by stress denial, a mere somatic orientation regarding etiology of symptoms, a manner of giving oral history indicating a distanced relationship to their body, and an expressed disapproval of the psychiatric part of the examination.

A Possible Genetic Contribution to the Alexithymia Trait

Alexithymic characteristics were studied in 15 monozygotic and 18 like-sex dizygotic healthy young twin pairs in a semistructured interview. Variance analysis showed larger within-pair variances in the dizygotic than in the monozygotic twins. With some reservations, these results point to a genetic influence on the etiology of the alexithymic phenomenon.

Short-term dynamic psychotherapy. I. The Oslo group's form to score outcome, the reliability testing of this form and observer characteristics.

The aim of short-term dynamic psychotherapy is, through working with a central conflict and transference reactions, to obtain lasting changes based on cognitive and emotional understanding of the main dynamics of the central conflict, called insight. The aim of the present study was to construct a follow-up form that was easy to handle, could score different outcome of short-term dynamic psychotherapy, as for instance symptom relief, change in social functioning and better insight, and was reliable. Sufficient reliability was established with a reliability coefficient between 0.756 and 0.564 for eight result variables. Percentage agreement was estimated in addition. As a total only 10% of the scores differed more than +/- 1 from a consensus score on a scale from zero, no change, to 7, recovered. The therapist was a reliable observer of his/her own patients. The sex of the observer did not influence percentage agreement. High-formal training in psychotherapy tended to give higher percentage of agreement compared to low-formal training.

Alexithymic Characteristics and Somatic Illness

As part of a study on stress, the author investigated 183 women, the majority of whom were dental patients. A highly significant correlation between a high score of alexithymic characteristics and many reported somatic diseases was found in the subjects who were 40 years of age or older.

Training in Short-Term Psychotherapy

Experiences in Norway since about 1970, are described in combined research and training on short-term dynamic psychotherapy. Research methodology and results are not discussed. Initiated by the Norweg

Short-term dynamic psychotherapy; three models of treatment.

Three types of short-term dynamic psychotherapy have been described. The selection of patients and the therapeutic interventions have been described briefly. Finally, illustrative case examples have been presented emphasizing the therapeutic outcome.

The Myofascial Pain Dysfunction Syndrome: An Unheeded Neuromuscular Disorder

Myofascial pain dysfunction (MPD) is characterized by repeated masticatory muscle pain alternating with a feeling of stiffness or fatigue in these muscles and limitation of function. Clicking or popping of the temporomandibular joint often is a precursor to the disorder or may be an accompanying symptom. There are no clinically, radiographically, or biochemically detectable changes in the passive parts of the masticatory system (i.e., the jaw bones, teeth, joints, or ligaments).2,3 The pain is localized to the ear, temple, or temporomandibular joint region. It usually lasts for weeks or months. It may vary but often becomes gradually worse. Some patients report that it may be difficult to open their mouths in the mornings and that they cannot easily eat breakfast. Others find that their problems become worse in the evenings. As a rule, there is a diurnal variation of symptoms. A few patients report diffuse, constant, aching pain. However it is not so severe that it interferes with sleep.