Dr. Adams' Alabama Headache Blog

Use of the Symptom Checklist ( SCL-90) is increasing in the research and treatment of Temporomandibular Disorders. To determine whether the dimensions assessed tend to be indicators of enduring tendencies or short term characteristics associated with pain, the SCL-90 and a 10-point numerical graphic analogue pain scale were administered to 50 TMD patients (TMDs) selected at random at the Gelb Craniomandibular and Orofacial Pain Center and 50 non-patient controls. TMD patients were treated by intraoral appliance therapy with regular adjustment visits. Three months after insertion, tests were readministered to both groups. Median pain levels for TMDs (5) decreased significantly to (2) according to the Wilcoxon Signed Rank Test (WRST. The median pain level for controls (1) remained unchanged (1), WRST. WRSTs performed on SCL-90 pre and post raw scores of TMDs showed significant reduction in all dimensions except Phobic Anxiety. Pre and post scores for controls were stable. The SCL-90 profile of the 42 TMDs who showed pain reduction was no different from that of the control group. Reduction in pain in all TMDs was significantly correlated with reduction in all psychological dimensions except Paranoid Ideation. No positive correlations were found for controls. The reductions of pain has broad psychological impact and the SCL-90 was found to be sensitive to it. These findings suggest strongly that with pain patients, scores on the majority of SCL-90 dimensions be considered part of a reactive pattern to pain. In the presence of pain, SCL-90 scores cannot serve as a valid indicator of enduring psychological tendencies. Without considering the transitory, score-elevating effect of pain, the origin of pain may, in whole or in part, be attributed to incorrectly to the dimensions elevated.