The Roles of Patients’ Authenticity and Accepting External Influence, and Clinicians’ Treatment Styles in Predicting Patients’ Dental Anxiety and Avoidance of Dental Appointments

A substantial proportion of adults suffer from high dental anxiety, which is related to poor oral health and functioning. Using authenticity theory and self-determination theory, we applied a model testing two moderated mediation hypotheses: (i) the negative indirect association between authenticity and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of autonomy support; and (ii) the indirect positive association between accepting external influence and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of controllingness. Participants (N = 208) responded to a survey with validated questionnaires. The model with hypotheses were tested using Structural Equation Modeling (SEM) in LISREL and Conditional Process Modeling (moderated mediation). The results supported our hypotheses. The SEM model tested was found to fit the data well. Patient’s personality and dental clinic treatment environments predicted 38% of the variance in dental anxiety, which explained 38% of avoidance of treatment.

[1]  Kennon M. Sheldon,et al.  Conditional Regard, Self-Concept, and Relational Authenticity: Revisiting Some Key Rogerian Concepts Cross-Culturally, Through Multilevel Modeling , 2020 .

[2]  William S. Ryan,et al.  Toward a Social Psychology of Authenticity: Exploring Within-Person Variation in Autonomy, Congruence, and Genuineness Using Self-Determination Theory , 2019, Review of General Psychology.

[3]  E. Deci,et al.  Attending and avoiding dental appointments: Do “bright” and “dark” motivational paths have a role? , 2018, International Journal of Dental Hygiene.

[4]  Zachary G Baker,et al.  Prevent the blue, be true to you: Authenticity buffers the negative impact of loneliness on alcohol-related problems, physical symptoms, and depressive and anxiety symptoms , 2017, Journal of health psychology.

[5]  E. Deci,et al.  Predicting dental attendance from dental hygienists’ autonomy support and patients’ autonomous motivation: A randomised clinical trial , 2017, Psychology & health.

[6]  J. Crawford,et al.  UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results , 2013, BMC Oral Health.

[7]  R. Freeman,et al.  Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care , 2013, BDJ.

[8]  B. Soenens,et al.  Parental psychological control and dysfunctional separation-individuation: a tale of two different dynamics. , 2012, Journal of adolescence.

[9]  E. Deci,et al.  Self-determined motivational predictors of increases in dental behaviors, decreases in dental plaque, and improvement in oral health: a randomized clinical trial. , 2012, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[10]  O. Vassend,et al.  Dental anxiety in relation to neuroticism and pain sensitivity. A twin study. , 2011, Journal of anxiety disorders.

[11]  G. Humphris,et al.  The prevalence of dental anxiety across previous distressing experiences. , 2011, Journal of anxiety disorders.

[12]  J. Reeve,et al.  A Meta-analysis of the Effectiveness of Intervention Programs Designed to Support Autonomy , 2011 .

[13]  A. Mattila,et al.  Anxiety and depressive disorders and dental fear among adults in Finland. , 2011, European journal of oral sciences.

[14]  Omri Gillath,et al.  Attachment, authenticity, and honesty: dispositional and experimentally induced security can reduce self- and other-deception. , 2010, Journal of personality and social psychology.

[15]  M. Vansteenkiste,et al.  Toward a domain-specific approach to the study of parental psychological control: distinguishing between dependency-oriented and achievement-oriented psychological control. , 2010, Journal of personality.

[16]  E. Deci,et al.  Motivation and anxiety for dental treatment: Testing a self-determination theory model of oral self-care behaviour and dental clinic attendance , 2010 .

[17]  Martin F. Lynch,et al.  On being yourself in different cultures: ideal and actual self-concept, autonomy support, and well-being in China, Russia, and the United States , 2009 .

[18]  I. Aartman,et al.  Negative events and their potential risk of precipitating pathological forms of dental anxiety. , 2009, Journal of anxiety disorders.

[19]  Kristopher J Preacher,et al.  Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models , 2008, Behavior research methods.

[20]  Stephen Joseph,et al.  The Authentic Personality: A Theoretical and Empirical Conceptualization and the Development of the Authenticity Scale , 2008 .

[21]  L. Bodin,et al.  Temperamental reactivity and negative emotionality in uncooperative children referred to specialized paediatric dentistry compared to children in ordinary dental care. , 2007, International journal of paediatric dentistry.

[22]  Kristopher J Preacher,et al.  Addressing Moderated Mediation Hypotheses: Theory, Methods, and Prescriptions , 2007, Multivariate behavioral research.

[23]  H. Halvari,et al.  Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory , 2006 .

[24]  J. Bergdahl,et al.  Temperament and character personality dimensions in patients with dental anxiety. , 2003, European journal of oral sciences.

[25]  T. Little,et al.  To Parcel or Not to Parcel: Exploring the Question, Weighing the Merits , 2002 .

[26]  K. Vohs,et al.  Case Western Reserve University , 1990 .

[27]  R. Poulton,et al.  Determinants of early- vs late-onset dental fear in a longitudinal-epidemiological study. , 2001, Behaviour research and therapy.

[28]  C. Bombardier,et al.  Guidelines for the process of cross-cultural adaptation of self-report measures. , 2000, Spine.

[29]  E. Deci,et al.  The "What" and "Why" of Goal Pursuits: Human Needs and the Self-Determination of Behavior , 2000 .

[30]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[31]  Kennon M. Sheldon,et al.  Trait Self and True Self: Cross-Role Variation in the Big-Five Personality Traits and Its Relations With Psychological Authenticity and Subjective Well-Being , 1997 .

[32]  D. Locker,et al.  Gender and age differences in attitudes to dental pain and dental control. , 1997, Community dentistry and oral epidemiology.

[33]  R. Baht,et al.  Antecedents of dental anxiety: learned responses versus personality traits. , 1997, Community dentistry and oral epidemiology.

[34]  E. Deci,et al.  Internalization of biopsychosocial values by medical students: a test of self-determination theory. , 1996, Journal of personality and social psychology.

[35]  S. West,et al.  Experimental personality designs: analyzing categorical by continuous variable interactions. , 1996, Journal of personality.

[36]  Per Capita,et al.  About the authors , 1995, Machine Vision and Applications.

[37]  R. P. McDonald,et al.  Structural Equations with Latent Variables , 1989 .

[38]  P. Milgrom,et al.  Treating fearful dental patients , 1987 .

[39]  R. Ryan,et al.  Autonomy in children's learning: an experimental and individual difference investigation. , 1987, Journal of personality and social psychology.

[40]  L. Sreebny.  Cereal availability and dental caries. , 1983, Community dentistry and oral epidemiology.

[41]  J. Cranage,et al.  The effect of fluoridation upon the relationship between caries experience and social class in 5-year-old children in Newcastle and Northumberland , 1980, British Dental Journal.

[42]  J. Nunnally,et al.  Psychometric Theory , 2020, Encyclopedia of Behavioral Medicine.

[43]  Edward L. Deci,et al.  Motivation for Dental Home Care: Testing a Self-Determination Theory Model , 2012 .

[44]  ünster,et al.  Motivation for Dental Home Care : Testing a Self-Determination Theory Model , 2012 .

[45]  C. Rogers.  A Theory of Therapy , Personality , and Interpersonal Relationships , as Developed in the Client-centered Framework , 2010 .

[46]  M. Kernis,et al.  A Multicomponent Conceptualization of Authenticity: Theory and Research , 2006 .

[47]  Julian F Thayer,et al.  Attentional and physiological characteristics of patients with dental anxiety. , 2003, Journal of anxiety disorders.

[48]  C. Knee,et al.  The integrating self and conscious experience , 2002 .

[49]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[50]  E. Deci,et al.  Motivational predictors of weight loss and weight-loss maintenance. , 1996, Journal of personality and social psychology.

[51]  C. A. D. de Wit,et al.  Review of behavioural research in dentistry 1987-1992: dental anxiety, dentist-patient relationship, compliance and dental attendance. , 1993, International dental journal.

[52]  R. May.  Freedom and Destiny , 1981 .

[53]  C. Rogers.  On Becoming a Person: A Therapist's View of Psychotherapy , 1961 .

[54]  K. Horney.  Neurosis And Human Growth , 1950 .