title: Methodological assessment of behavioural problem dimensions in adults with dental fear.
abstract: OBJECTIVE
  In the assessment and treatment of persons with dental fear, there may be other psychological/behavioural factors than fear itself and traditional measures of psychopathology that should be considered. Longitudinal natural history studies are needed to find such variables. The present study investigated whether the same behavioural problem dimensions (internalizing, externalizing, attention) found among children and adolescents with behaviour management problems and/or dental fear could also be found among severely fearful adult patients.
  
  
  METHODS
  The participants were 230 consecutive adult patients applying for treatment for severe dental anxiety at a specialized clinic. Patients completed a version of the Rutter behaviour questionnaire that was adapted for adults. Comparison data were the Hospital Anxiety and Depression scale and self-rated anger evoked by dental fear. Background data, including dental fear, were also collected. Descriptive statistics, principal components analyses, group comparisons and correlations were calculated.
  
  
  RESULTS
  Of the three behaviour problems scales we adapted for adults, two (Internalizing and Attention) had acceptable psychometric properties and meaningful relations with the comparison variables. In contrast, the third problem scale (Externalizing) proved to have less satisfactory properties and relations, especially for men. Patients with severe phobia had higher levels of problem behaviours than patients with less severe phobia.
  
  
  CONCLUSIONS
  Internalizing and Attention scales for adults seem promising for use in future prospective studies of the natural history of dental fear. The Externalizing scale, however, needs to be studied with a wider range of comparison variables and measures of social desirability.
authors.affiliation: Health Care Research Unit, Institute of Medicine, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. magnus.elfstrom@medicine.gu.se
authors.forename: Magnus L
authors.initials: ML
authors.lastname: Elfström
authors.forename: Jesper
authors.initials: J
authors.lastname: Lundgren
authors.forename: Ulf
authors.initials: U
authors.lastname: Berggren
mesh_terms: D000328:Adult; D000368:Aged; D000786:Anger; D001007:Anxiety / Q000523:psychology; D001288:Attention; D001294:Attitude to Health; D016854:Dental Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011594:Psychometrics; D011595:Psychomotor Agitation / Q000523:psychology; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology