Does emotional, physical and/or sexual abuse influence scores in somatization in subjects with Craniomandibular Disorders and Bruxing Behavior?

Introduction: It s now accepted that many temporomandibular disorder patients may suffer from somatization disorders. Somatization is described as the transformation of deep psychological conflicts into body complaints or illnesses. Goals: Evaluate scores in somatization in craniomandibular disorders and bruxing behavior individuals with different types of abuse and test the hypothesis that somatization scores will increase in such subjects if reporting multiple types of abuse. Methods: Clinical examination, history of the chief complaint to evaluate craniomandiblar disorders, questionnaires and clinical examination for bruxing behavior, and psychological measures including the Rief and Hiller instrument for somatization and the Saunders and Becker-Lausen instrument for childhood maltreatment were utilized to evaluate 73 individuals with craniomandibular disorders, bruxing behavior, emotional, physical and sexual abuse; 101 individuals with craniomandibular disorders, bruxing behavior and emotional and physical abuse, 62 subjects with CMDs and emotional abuse, 24 subjects with craniomandibular disorders, bruxing behavior and physical abuse, 51 individuals with craniomandibular disorders and no abuse (Control) and 30 subjects with no craniomandibular disorders and no abuse (control). The Kruskal-Wallis and Dunn ́s test were used to evaluate significant differences when the groups were compared. Results: Mean ages in the CMDs + Emotional + Physical + Sexual abuse; CMDs + Emotional + Physical Abuse; CMDs + Emotional Abuse; CMDs + Physical Abuse; CMDs No Abuse and No CMDs and No Abuse were about 38,6 years (SD=12,4, range 18-66); 35,2 (SD=13,5, range-17-70); 30,4 (SD=11,1, range=17-53); 36,8 (SD=15,3, range 18-75); 33,4 (SD=13,3, range= 18-61); 33,0 (SD=14,2, range=17-73), respectively. There was no statistically and significant difference when age was compared one group with the other (Kruskal-Wallis statistics p=0.06). See Table 1 for additional details. Mean somatization scores in the aforementioned subgroups were about 14,3 (SD=6,1, range=4-28); 12,2 (SD=4,9, range=0-28); 11,4 (SD=5,3, range= 3-24); 11,2 (SD=5,6, range= 4-28); 8,2 (SD=4,9, range=1-18); 4,5 (SD=3,4, range=0-12), respectively. Kruskal-Wallis statistics (p<0,0001). Statistically significant differences were only observed in the subgroups as follows: CMDs + Emotional + Physical + Sexual abuse subgroup versus CMDs No Abuse subgroup (p<0,001); CMDs + Emotional + Physical + Sexual subgroup versus No CMDs No Abuse subgroup (p<0,001); CMDs + Emotional + Physical subgroup versus CMDs No Abuse (p<0,001); CMDs + Emotional + Physical subgroup versus No CMDs No Abuse subgroup (p<0,001); CMDs + Emotional subgroup versus No CMDs No Abuse subgroup (p<0,001); CMDs + Physical Abuse subgroup versus No CMD No Abuse subgroup (p<0,001), respectively. Conclusion: Somatization scores were higher in the CMDs subgroup of CMDs + emotional + Physical + sexual abuse when compared with the two control subgroups. CMDs subjects with emotional, physical and emotional abuse did not demonstrate higher scores in somatization when compared with the CMDs with emotional + physical abuse or with only emotional or with only physical abuse; the effect of emotional + physical + sexual abuse was not cumulative in the amount of somatization when compared with only one type of abuse in CMDs subjects.