What do anxious patients think? An exploratory investigation of anxious dental patients' thoughts

According to BECK's cognitive model of emotional disorders (1976) anxiety is associated with negative and threatening thoughts concerning the likelihood of personal danger. In the present study the content of thoughts of 32 anxious dental patients was investigated. Patients' mean score for the Dental Anxiety Scale was 17.1 (SD = 2.0). The average time period patients had not visited a dentist was 9.1 yr (SD = 8.7). Using semi-structured interviews 132 thoughts were explored. The mean number of thoughts reported per patient was 4.1 (SD = 1.6). Almost all patients reported thoughts in some way related to their fear. All patients except one reported self-verbalizations of a negative or catastrophizing nature. Nine different categories of the content of the thoughts were identified. Nine percent of the thoughts consisted of visual images. The largest category (23%) consisted of catastrophic thoughts about the patient's own functioning during dental treatment, e.g., thoughts about losing control, panicking and dying. Fifty-nine percent of the patients reported thoughts of this type. The findings provide support for BECK's cognitive model of emotional disorders.