Predictors of behavioral avoidance in dental phobia: The role of gender, dysfunctional cognitions and the need for control

Abstract

Dental anxiety and the related avoidance of dental treatment can result in severe impairment of health. We investigated the influence on avoidance behavior of phobic severity, gender, characteristics related to generalized anxiety and depression, such as dysfunctional cognitions and sensitivity of bodily symptoms, as well as personality traits of self-efficacy and locus of control. Forty-eight dental phobics were given an initial assessment and avoidance behavior was determined by the degree of observance of three subsequent dental appointments. Principal component analysis revealed separate factors for trait and phobic anxiety as well as for avoidance and dysfunctional cognitions. Women showed a higher degree of avoidance than men. Regression analysis revealed a high desire for control over dental treatment combined with a low level of perceived control as the only significant predictor variable of avoidance. The results suggest that avoidance behavior in dental phobia could be reduced by extending patients’ control over treatment conditions.

Keywords:

• Controllability
• dental anxiety
• dysfunctional cognitions
• phobic avoidance

This study was carried out with the support of the Deutsche Forschungsgemeinschaft (SA 735/13-1,2). We are grateful to Belinda Sistig and Susanne Klimesch for their help with the data collection.