University of Oulu

Aisha Banafa, Anna Liisa Suominen & Kirsi Sipilä (2023) Association between cynical hostility and temporomandibular pain mediated through somatization and depression: an 11-year follow-up study on Finnish adults, Acta Odontologica Scandinavica, 81:1, 79-85, DOI: 10.1080/00016357.2022.2085323

Association between cynical hostility and temporomandibular pain mediated through somatization and depression : an 11-year follow-up study on Finnish adults

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Author: Banafa, Aisha1; Suominen, Anna Liisa1,2,3; Sipilä, Kirsi4,5
Organizations: 1Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
2Department of Oral and MaxillofacialDiseases, Kuopio University Hospital, Kuopio, Finland
3Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare(THL), Helsinki, Finland
4Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
5Oral andMaxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.3 MB)
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Language: English
Published: Informa, 2022
Publish Date: 2023-01-03


Background: Hostility is believed to have an adverse effect on physical health through mediating psychosocial factors.

Objectives: This study aimed to investigate the association of hostility with temporomandibular (TMD) pain. Another aim was to investigate if the association is mediated through increases in depressiveness and somatization in an 11-year follow-up on Finnish adults, based on the Health 2000 and 2011 Surveys (BRIF8901).

Material and methods: The sample comprised subjects who underwent clinical TMD pain examination (pain on palpation of the masticatory muscles and temporomandibular joints) in 2000 and 2011 and responded to questions on TMD pain symptoms in 2011. Hostility was measured using the Cynical Distrust Scale, somatization was measured using the Symptom Checklist-90, and depressiveness using Beck’s Depression Inventory-21. Four subgroups were formed based on the presence of TMD pain: no pain, pain in 2000 only, pain in 2011 only, and pain in 2000 and 2011. Analyses included chi-square test cross-sectionally, and multinomial logistic regression longitudinally with the level of hostility in 2000 as the predictor. Mediation analysis was performed using Hayes’ Process v3.5.

Results: Those with higher hostility showed a higher prevalence of TMD pain. Longitudinally, the association of hostility with TMD pain in 2000 only, and with TMD pain in both years, was mediated either by somatization only or by depressiveness that was mediated by somatization. In those with TMD pain in 2011 only, the association was mediated by depressiveness that was mediated by somatization.

Conclusion: Hostility increased the risk of TMD pain through increases in depressiveness and somatization.

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Series: Acta odontologica Scandinavica
ISSN: 0001-6357
ISSN-E: 1502-3850
ISSN-L: 0001-6357
Volume: 81
Issue: 1
Pages: 79 - 85
DOI: 10.1080/00016357.2022.2085323
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Copyright information: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Acta Odontologica Scandinavica Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way,