Psychosocial-Behavioural Phenotypes and Temporomandibular Disorder Risk: Insights From a Latent Class Analysis in...

Psychosocial and behavioural factors shape temporomandibular disorders (TMDs), yet integrated phenotyping in Southeast Asian young adults remains limited. University students, a vulnerable subgroup of young adults, face heightened risk.

To identify latent psychosocial-behavioural classes in this cohort and assess associations with sociodemographic factors and TMD severity.

A cross-sectional study of participants aged 18-30 years used validated instruments to assess distress (Patient Health Questionnaire-4; PHQ-4), somatic symptoms (PHQ-15), oral behaviours (Oral Behaviours Checklist; OBC), and TMDs (Short-form Fonseca Anamnestic Index; SFAI). Latent class analysis (LCA) was performed on PHQ-4, PHQ-15, and OBC scores, estimating one- to five-class models. Class differences were tested using χ² and Kruskal-Wallis/Dunn's procedures. Predictors of class membership were evaluated using multinomial logistic regression (α = 0.05).

Three classes emerged: Resilient (56.1%), Moderate-Vulnerability (30.4%), and High-Risk (13.5%). TMD prevalence was highest in High-Risk (45.0%), intermediate in Moderate-Vulnerability (25.6%), and lowest in Resilient (10.0%). Depression (OR = 12.34), anxiety (OR = 13.03), somatic burden (OR = 4.91), and oral behaviours (sleeping-state OR = 1.77; waking-state non-functional OR = 1.70; waking-state functional OR = 1.44) significantly predicted High-Risk membership. Sociodemographic factors and TMD severity differentiated classes descriptively but lacked predictive strength.

LCA delineated three psychosocial-behavioural phenotypes, with depression, anxiety, and somatic burden most strongly defining High-Risk membership, and oral behaviours adding incremental risk. Findings underscore upstream psychosocial-behavioural determinants as key prevention targets, while downstream outcomes guide tailored interventions in young adults.