Social Science and Dentistry

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September 2013
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The Cognitive Vulnerability Model and its role in dental anxiety acquisition and maintenance

Objective: To further explore the Cognitive Vulnerability Model (CVM) in relation to the acquisition and maintenance of dental anxiety/phobia. Within this, a key aim was to develop a more comprehensive questionnaire for both the aetiology and maintenance of dental anxiety in relation to the CVM. Methods: An opportunity sample of 378 participants was recruited in Cyprus. They completed a standardised dental anxiety measure; two scales designed specifically to assess the four components of the CVM (uncontrollability, unpredictability, dangerousness, and disgustingness) in the acquisition and maintenance of their fear; and an open-ended question asking participants’ perceived origins of their dental anxiety. Results: There was preliminary support for the psychometric properties of the newly developed questionnaire. Forced Entry regression analysis revealed that the CVM variables were all significant predictors of the dental anxiety maintenance, explaining 36% of the variance. However, unpredictability was not found to have a significant independent relationship with current dental anxiety. Content analysis for the open-ended responses showed that almost all of the responses could be categorised into CVM components. Regression analysis revealed that only unpredictability had a significant relationship with how participants perceived they acquired their fear. These findings show further support for the role of the CVM in maintaining dental anxiety. However, support for the CVM as a model of dental fear acquisition needs further investigation. Conclusion: Specific cognitive vulnerability components are important indicators of current dental fear. Efforts to alleviate dental fear should focus on addressing these cognitions to help dentally anxious individuals to access regular dental care.

Key words: Anxiety, cognitive vulnerability, dental fear

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Gogem Topcu, Heather Buchanan

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  1. The Cognitive Vulnerability Model and its role in dental anxiety acquisition and maintenance
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