Ulla Wide Boman

Women with Turner syndrome: Psychological well-being, self-rated health and social life

Psychological well-being, self-rated health and social situation were investigated in a cross-sectional multidisciplinary study of 63 women with Turner syndrome (TS; mean age 31.5 years, range 18-59 years). The psychological examination included a semi-structured interview, and use of two standardized self-rating scales, the Psychological General Well-being Index (PGWB) and the Nottingham Health Profile (NHP). Psychological well-being and self-rated health were similar in the women with TS and Swedish female normative data, matched for age. However, the women with TS reported more social isolation than the normative group. Within the TS group, the oldest women reported more psychological distress and poorer health than the youngest. Those with impaired self-rated health reported more emotional distress. The women with TS were studying or in employment to the same degree as the general population, although fewer were cohabiting. In the interview, both negative and positive consequences of TS were reported. This study did not find any evidence for impaired psychological well-being, although it did indicate that women with TS experience more difficulties in the area of social and partner relationships.

Sexual Functioning and Partner Relationships in Women with Turner Syndrome: Some Empirical Data and Theoretical Considerations Regarding Sexual Desire

The aim of this study was to describe marital status, sexual history, and sexual functioning in a group of women with Turner syndrome, and to compare the results with general Swedish population data. The sample consists of 57 women over 18 years of age. Data were collected from an interview, and using two self-report questionnaires: the McCoy Sexual Rating Scale and the Relationship Rating Scale (RS). Compared to population data, the women with Turner syndrome were less likely to have a partner and had had their sexual debut later. Single women differed more from the general population than did women with a partner, regarding sexual desire and sexual activity. Several women with a partner reported sexual problems, but unanimously reported being satisfied with their sex life and partner relationship. The level of sexual desire in women with Turner syndrome is discussed in relation to Levines model of human sexual desire, where psychological and social motivational factors are considered in addition to a biologically based sexual drive (Levine, 1992).

Oral health-related quality of life, sense of coherence and dental anxiety: an epidemiological cross-sectional study of middle-aged women.

BackgroundFew publications report on the relationship between salutogenesis, as measured by the concept of sense of coherence, and oral health-related quality of life. Even less information is to be found when the behavioural aspect of dental anxiety is added. The aim of the present study was to evaluate how oral health-related quality of life is related to sense of coherence and dental anxiety.MethodThe study had a cross-sectional design and included 500 randomly selected women in Gothenburg, Sweden, 38 and 50 years of age, from health examinations in 2004–05. The survey included questionnaires covering global questions concerning socio-economic status, oral health/function and dental care behaviour, and tests of oral health-related quality of life, sense of coherence, and dental anxiety.ResultsHigh dental anxiety and low sense of coherence predicted low oral health-related quality of life. In addition, socioeconomic status as measured by income, perceived oral functional status as captured by chewing ability and self-reported susceptibility to periodontal disease were also important predictors of oral health-related quality of life.ConclusionDental anxiety and sense of coherence had an inverse relationship with regard to oral health-related quality of life. These associations were stronger than other risk factors for low oral health-related quality of life.

Dental anxiety and temperament in 15-year olds

OBJECTIVE The aim of the present study was to analyze the prevalence of dental anxiety and its association with temperament, sociodemographic factors and previous painful and unpleasant experiences of dental care among 15-year old individuals. MATERIALS AND METHODS The sample included 263 randomly selected 15-year old individuals living in the municipality of Jönköping, Sweden. The school, parental and adolescent consent was acquired. Three self-reported questionnaires were used, one included items of sociodemography, while the others dealt with dental anxiety assessed by the Dental Fear Survey (DFS) and temperament assessed by an adapted version of The EAS Temperament Survey for Children modified for adults, the EASI temperament survey. RESULTS The results showed that 6.5% of the adolescents were classified as dentally anxious and with girls proportionally more fearful than boys. The three temperaments activity, impulsivity and emotionality were significantly correlated with dental anxiety. A hierarchical multiple linear regression analysis showed that pain at the last dental appointment or previous pain experiences during dental care treatment were the strongest predictors regarding dental anxiety in 15-year olds. The temperament dimensions activity and impulsivity were also significantly predictive of dental anxiety. CONCLUSIONS Although some of the temperament dimensions are correlated with dental anxiety, which may emphasize an important finding with regard to personality, this study showed that previous pain experiences during dental care treatment is a strong predictor for high dental anxiety in 15-year olds.

Dental anxiety – a joint interest for dentists and psychologists

This introductory article to the Symposium on Behavioral and Community Dentistry aims to describe the development of research and clinical work on dental anxiety, and includes a discussion of the historical background and the evolution since the 1970s. In view of its pioneering activities in this regard, special focus is placed on research and development at the Institute of Odontology of the University of Gothenburg, Sweden.

Attention deficit hyperactivity disorder and dental anxiety in adults: relationship with oral health

The aim of the present study was to investigate the presence of attention deficit hyperactivity disorder (ADHD) in adult patients with severe dental anxiety. Specifically, we analysed the relationship among ADHD, oral health, and dental anxiety. The World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener was administered to a consecutive sample of patients referred to a dental fear research and treatment clinic. Patients completed questionnaires measuring dental anxiety (Dental Fear Survey) and self-rated oral health, and underwent a full radiographic examination. Of the total sample (n = 110), 16% scored above the established ASRS cut-off point, which is indicative of having ADHD. The ADHD group showed a higher level of dental anxiety and poorer self-rated oral health. There were also indications of poorer clinical oral health in the ADHD group, but these results did not reach statistical significance. In conclusion, the results of this study indicate an increased prevalence of ADHD in highly dentally anxious adults and the need to pay special attention to these patients because of greater treatment needs and increased dental anxiety.

Translation and psychometric properties of the Swedish version of the Index of Dental Anxiety and Fear (IDAF-4C+)

Dental anxiety (DA) is a common condition, with significant medical, psychological, and social consequences. High-quality psychometric tools for the assessment of dental anxiety are necessary for clinical and research purposes. The aim of this study was to adapt the Index of Dental Anxiety and Fear (IDAF-4C(+) ) to the Swedish language and to explore the psychometric properties of the translated version. The study included a clinical sample (n = 414; 17-91 yr of age) and a non-clinical sample (n = 51; 19-47 yr of age). The scales used were the IDAF-4C(+) , the Single-Question Assessment of Dental Anxiety (SQDA), the Dental Fear Survey (DFS), and the Internal Health Locus of Control (IHLOC). The Swedish IDAF anxiety module showed a clear, one-dimensional structure, good internal consistency (Cronbachs alpha = 0.95), and adequate validity, as evidenced by strong correlations with the other DA measures (SQDA and DFS) and weak correlations with the IHLOC. In addition, the IDAF phobia module and the IDAF stimulus module were strongly correlated with the other DA measures. To conclude, the study shows promising findings for the reliability and validity of the Swedish translation of the IDAF-4C(+) , as a useful measure of dental anxiety in research and clinical practice.

General fearfulness, attitudes to dental care, and dental anxiety in adolescents

The etiology of dental anxiety (DA) may involve a spectrum of factors related to past dental experiences, general and specific fears, and other personality factors, but is relatively unexplored in adolescents. The aim of this study was to examine how general fearfulness and attitudes to dental care/personnel were related to DA in 15-yr-old subjects. The sample included 263 randomly selected 15-yr-old adolescents living in the municipality of Jönköping in southern Sweden. Four questionnaires were used: one general questionnaire regarding background data and three psychometric instruments dealing with DA, general fearfulness, and dental beliefs. Of all participants, 6.5% were classified as having DA. Dental anxiety was moderately to strongly correlated both with attitudes to dental care/personnel and with general fearfulness and indicated the strongest impact for individuals with both high general fearfulness and high dental beliefs in relation to DA. The linear multiple regression analysis showed that the best predictors of DA were general fearfulness and dental beliefs. This suggests that both individual vulnerability in terms of generalized fear and apprehensions about dental staff, which is linked to experiences of dentistry, appear to be important factors for DA and may be considered as risk factors for DA in adolescents.

Orofacial esthetics and dental anxiety: Associations with oral and psychological health

Abstract Objective. Severe dental anxiety (DA) is associated with both oral health and psychosocial consequences in what has been described as a vicious circle of DA. The aim of this study was to investigate self-rated orofacial esthetics in patients with DA and its relationship to psychological and oral health. Materials and methods. A consecutive sample of 152 adult patients who were referred or self-referred to a specialized dental anxiety clinic filled out the Orofacial Esthetic Scale (OES) as well as measurements on DA, self-rated oral health and general anxiety and depression. Clinical measures of dental status were also obtained. Results. Compared with the general population, patients with DA had lower ratings of satisfaction on all aspects of their orofacial esthetics, which included the teeth, gingiva, mouth and face, as well as a global orofacial assessment. Furthermore, the perception of the orofacial appearance was related both to dental status and self-rated oral health, as well as to general anxiety and depression. The level of dissatisfaction with the orofacial appearance was similar for both genders, but women reported more regular dental care and better dental status. Conclusions. The results of this study clearly show less satisfaction with dental and facial appearance in patients with DA, and that the self-rating of orofacial esthetics is related to both oral and psychological health. The OES can be used to assess orofacial esthetics in patients with DA.

Dental care attendance and refrainment from dental care among adults

Abstract Objective: The aim of this study was to analyse dental care utilization, refrainment from self-perceived needed dental care and the association with socioeconomic indicators among adult individuals. Materials and methods: This cross-sectional survey included 3500 randomly selected adult individuals. Telephone interviews were conducted and the participants answered a battery of questions regarding dental visiting habits, health, socioeconomic position (SEP), behavioural factors and lifestyle indicators. Results: The outcome ‘dental visits’ was significantly correlated with SEP, especially with monetary dimensions, such as income and economic resources for unforeseen expenditures. However, educational level was not a significant predictor in the tested statistical models. Furthermore, other covariates that contributed significantly to the models were ethnicity, dental anxiety and lifestyle factors, albeit with a different pattern of impact on the two outcome dimensions. Important features of the SEP variables were the stepwise gradient relative to the outcomes, implicating that the lower the SEP status, the greater the risk of reporting irregular dental visiting habits and refraining from dental care due to financial problems. Conclusions: Dental care utilization and refraining from dental care for financial reasons clearly reveal associations with socioeconomic positions among adult individuals.