Validity of a Single-Item Stress Measure in TMD-Pain Patients

There is growing evidence for the observation that stress has an impact on developing and maintaining temporomandibular disorder (TMD) pain. There are various self-report questionnaires available for the assessment of stress. However, completing questionnaires with several items can be time-consuming for both the patient and the clinician. Therefore, the use of a single-item stress measure could be beneficial.

To investigate the validity of a single-item stress measure in adults by comparing it to an existing, more comprehensive stress measure, as well as to other psychosocial constructs, specifically depression, anxiety and somatic symptoms.

822 patients who were referred to a specialty clinic for orofacial pain and dysfunction participated in this study. All patients completed a set of diagnostic questionnaires, assessing, among others, TMD symptoms, stress (PSS-4 and single-item stress measure), depression (PHQ-9), anxiety (GAD-7) and somatic symptoms (PHQ-15). Correlational analyses were used to assess the associations between the single-item stress measure and each of the total scores of the PSS-4, PHQ-9, GAD-7 and PHQ-15.

Moderate correlations were found between the scores on the single-item stress measure and the scores on PSS-4 (0.507), PHQ-9 (0.493) and GAD-7 (0.619). The PHQ-15 was weakly correlated with the single-item stress measure (0.350).

The single-item stress measure is positively associated with the PSS-4 and each of the psychosocial constructs. This suggests that the single-item stress measure could be used as a valid substitute for the PSS-4, i.e., a comprehensive stress measure commonly used in specialty clinics for orofacial pain and dysfunction.