Repressive coping style and anxiety in stressful dental surgery

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Abstract
Elevated state‐anxiety prior to oral surgery is common and is associated with increased post‐operative pain. This paper presents a psychological model of predicting elevated anxiety prior to dental surgery. Elevated anxiety and intraoperative stress can be predicted by measuring trait‐anxiety. However, prediction may be improved by using a situationally specific measure of trait‐anxiety, and by taking the patient's coping style into account. Thirty‐nine patients undergoing wisdom‐tooth extraction took part in the study. The Corah Dental Anxiety Scale was a better predictor of pre‐operative anxiety than the STAI trait‐anxiety scale. Coping style was measured by means of the Marlowe‐Crowne Social Desirability Scale in conjunction with scores on trait‐anxiety to define three coping style groups: sensitizers (high‐anxious), truly low‐anxious, and repressors who verbally deny anxiety. Two oral surgeons rated patient intra‐operative state on 100 mm visual analogue scales. These ratings indicate that ‘repressors’ exhibit significantly more stress responses than the truly low‐anxious group, in spite of similar (low) trait‐anxiety scores. It is concluded that a situationally specific measure of trait‐anxiety is the most appropriate predictor of differential state‐anxiety elevations prior to oral surgery. Repressive coping style may be a confounding factor, in terms of predicting elevated anxiety, since some people verbally deny being anxious but express it behaviourally.

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