J Oral Med Pain.  2023 Jun;48(2):45-55. 10.14476/jomp.2023.48.2.45.

Catastrophizing as a Key Factor for Understanding Posttraumatic Trigeminal Neuropathy: A Preliminary Study

• Kim HK
• Kim ME

• KMID: 2552138
• DOI: http://doi.org/10.14476/jomp.2023.48.2.45

Abstract

Purpose
Limited literature exists regarding psychological relevance to pain experience and disability in patients with painful posttraumatic trigeminal neuropathy (PPTTN), which is well-known for its treatment-refractory features and considerable impact on the quality of life. Thus, this study aimed to examine the biopsychosocial risk factors for pain disability in patients with PTTN.
Methods
A comprehensive set of self-administered questionnaires was used to assess biopsychosocial features in patients with PPTTN. The questionnaires comprised the Brief Pain Inventory (sensory dimension), Symptom Checklist-90-Revised (affective dimension), Pain Catastrophizing Scale (PCS, cognitive dimension), and Pittsburgh Sleep Quality Index (sleep quality). Sensory clinical examinations were also conducted.
Results
Data were obtained from 32 patients with PPTTN who had a median pain duration of 16 months. Injuries to the inferior alveolar nerve and lingual nerve accounted for 71.9% and 28.1% of all injuries, respectively. Most patients showed high levels of pain catastrophizing (71.9%) and poor sleep quality (87.5%). Unlike affective distress and sleep quality, the mean scores of the three subscales and the global scores of PCS were significantly higher in patients with high pain interference than those with low pain interference. Pain severity and the PCS “helplessness” subscale were significant risk factors for pain interference in patients. Significance was observed for the final model with two predictors, explaining 86.5% of the pain interference variance. Additional analyses revealed that the PCS scores were not correlated with sensory features of PPTTN. However, they were associated with affective distress and subjective sleep quality.
Conclusions
The study findings indicate that the key role of pain-specific helplessness as a determinant of pain disability associated with PPTTN may provide insight into an enhanced understanding and management of pain disability in patients with PPTTN.

Keyword

Catastrophization; Psychology; Trigeminal nerve injuries