Trauma Exposure and Childhood Trauma in Temporomandibular Joint Disorders

NCT07292103 | Completed

• 1 other identifier: 197/2025
• Study Type: observational
• Target: 102
• Locations: 1 country
• Sites: 1

Brief Summary

Temporomandibular disorder is a multifactorial condition that involves the temporomandibular joint, masticatory muscles, and surrounding structures and is influenced by biological, psychological, and social factors. Parafunctional habits, bruxism, trauma, and occlusal discrepancies have been recognized as important etiological contributors, while psychosocial stressors and early life experiences also play a critical role. Adverse childhood experiences, including neglect and abuse, have been identified as risk factors for long-term psychological vulnerability and physical health problems. Trauma exposure throughout life may further increase the risk of temporomandibular symptoms and negatively affect functional outcomes and quality of life. The present prospective, cross-sectional case-control study aims to investigate the frequency and impact of childhood trauma and lifetime trauma exposure on functional outcomes and health-related quality of life in patients with temporomandibular disorder. A clinical sample of patients diagnosed with temporomandibular disorder is compared with healthy individuals matched for age and sex. All participants complete standardized questionnaires assessing mandibular function, symptoms of anxiety and depression, cumulative trauma exposure across childhood, adolescence, and adulthood, childhood maltreatment, and health-related quality of life. By systematically integrating validated measures of both early and later traumatic experiences, this study seeks to provide a comprehensive understanding of the contribution of trauma to the severity and psychosocial burden of temporomandibular disorder. The findings are expected to emphasize the importance of incorporating trauma screening and psychological assessment into the routine evaluation and multidisciplinary management of patients with temporomandibular disorder.

Conditions

Temporomandibular Disorder; Temporomandibular Joint Dysfunction; Trauma Exposure; Childhood Traumas; Psychological Distress; Quality of Life Impairment

Keywords

Temporomandibular Joint Disorder; Temporomandibular Disorder; Temporomandibular Dysfunction; Mandibular Function Impairment Questionnaire; Hospital Anxiety and Depression Scale; International Trauma Exposure Measure; Childhood Trauma Questionnaire; Short Form-36 Health Survey; Trauma Exposure; Childhood Maltreatment; Adverse Childhood Experiences; Anxiety; Depression; Psychosocial Factors; Quality of Life

Outcome Measures

Primary Outcomes (2)

• International Trauma Exposure Measure

  The International Trauma Exposure Measure is a standardized checklist designed to evaluate exposure to potentially traumatic events according to the definition of trauma in the International Classification of Diseases, Eleventh Revision. The instrument assesses trauma exposure across three developmental periods: childhood (0-12 years), adolescence (13-18 years), and adulthood (older than 18 years). Subscale scores are calculated separately for each developmental period, and a cumulative lifetime trauma score is obtained by summing all reported events across the lifespan. The Turkish version of the International Trauma Exposure Measure has been validated and demonstrates strong reliability and psychometric properties.

  At baseline

• Childhood Trauma Questionnaire

  The Childhood Trauma Questionnaire is a 28-item self-report instrument that retrospectively assesses experiences of childhood maltreatment. It consists of five subscales: physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. Three additional items assess denial or minimization of abuse. Each item is scored on a five-point Likert scale ranging from 1 (never true) to 5 (very often true). Higher subscale and total scores indicate greater severity of childhood trauma. The Turkish adaptation of the Childhood Trauma Questionnaire has been validated and has demonstrated high internal consistency and test-retest reliability.

  At baseline

Secondary Outcomes (3)

• Mandibular Function Impairment Questionnaire

  At baseline

• Hospital Anxiety and Depression Scale

  At baseline

• Short Form 36 Health Survey

  At baseline

Study Arms (2)

Temporomandibular Disorder Group

Adults aged 18 to 65 years with a clinical diagnosis of temporomandibular disorder were included. Participants were cognitively competent, literate, and provided written informed consent. All participants completed structured interviews and standardized questionnaires, including the Mandibular Function Impairment Questionnaire, the Hospital Anxiety and Depression Scale, the International Trauma Exposure Measure, the Childhood Trauma Questionnaire, and the Short Form 36 Health Survey.

Healthy Control Group

Adults aged 18 to 65 years without a clinical diagnosis of temporomandibular disorder were included. The control group was matched to the patient group according to age and sex. All participants were cognitively competent, literate, and provided written informed consent. Participants in the control group completed the same structured interviews and standardized questionnaires as the patient group, including the Mandibular Function Impairment Questionnaire, the Hospital Anxiety and Depression Scale, the International Trauma Exposure Measure, the Childhood Trauma Questionnaire, and the Short Form 36 Health Survey.

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study included adults aged 18 to 65 years who were recruited from the Otorhinolaryngology outpatient clinic of Gaziantep City Hospital, Türkiye. The patient group consisted of individuals who were clinically diagnosed with temporomandibular disorder, while the control group comprised healthy volunteers without a diagnosis of temporomandibular disorder who were matched to the patient group for age and sex. All participants were cognitively intact, literate, and provided written informed consent prior to participation.

You may qualify if:

• Adults aged 18 to 65 years
• Clinically diagnosed with temporomandibular disorder according to standardized clinical evaluation
• Cognitively competent and literate individuals capable of completing questionnaires
• Voluntary agreement to participate and provision of written informed consent

You may not qualify if:

• History of neurological, psychiatric, or systemic diseases that may affect study participation or data reliability
• Cognitive impairment that prevents completion of questionnaires
• History of major maxillofacial surgery or trauma not related to temporomandibular disorder
• Current substance abuse or alcohol dependence
• Refusal or inability to provide informed consent

Sponsors & Collaborators

• Gulseren Demir Karakilic: lead
• Bozok University: collaborator
• Gaziantep City Hospital: collaborator

Study Sites (1)

Yozgat Bozok University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Yozgat, Yozgat, 66100, Turkey (Türkiye)

Location

Related Publications (6)

• Kocyigit, H., Turkish validity and reliability of short-form 36. Drug Treat, 1999. 12: p. 102-106

  BACKGROUND

• Şar, V., P.E. ÖZTÜRK, and E. İkikardeş, Çocukluk çağı ruhsal travma ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirliği. Turkiye Klinikleri Journal of Medical Sciences, 2012. 32(4): p. 1054-1063.

  BACKGROUND

• Gündoğmuş, İ., et al., Psychometric properties of the Turkish version of the International Trauma Questionnaire. Journal of Aggression, Maltreatment & Trauma, 2023. 32(12): p. 1847-1865.

  BACKGROUND

• Hyland P, Karatzias T, Shevlin M, McElroy E, Ben-Ezra M, Cloitre M, Brewin CR. Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM-5. Psychol Trauma. 2021 Feb;13(2):133-141. doi: 10.1037/tra0000908. Epub 2020 Sep 10.

  PMID: 32915045 BACKGROUND

• Aydemir, Ö., et al., Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg, 1997. 8(4): p. 280-7.

  BACKGROUND

• Kılınç, H.E., et al., Further Validity and Reliability of Turkish Version of the Mandibular Functional Impairment Questionnaire in Patients with Temporomandibular Dysfunction. Journal of Basic and Clinical Health Sciences, 2022. 7(1): p. 214-222.

  BACKGROUND

MeSH Terms

Conditions

Temporomandibular Joint Disorders; Depression; Anxiety Disorders

Condition Hierarchy (Ancestors)

Craniomandibular Disorders; Mandibular Diseases; Jaw Diseases; Musculoskeletal Diseases; Joint Diseases; Muscular Diseases; Stomatognathic Diseases; Behavioral Symptoms; Behavior; Mental Disorders

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor, Principal Investigator

Study Record Dates

• First Submitted: December 5, 2025
• First Posted: December 18, 2025
• Study Start: May 22, 2025
• Primary Completion: October 10, 2025
• Study Completion: October 10, 2025
• Last Updated: December 29, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: De-identified individual participant data and supporting documents will be available after publication of the study results and will remain accessible for five years following publication.
• Access Criteria: Researchers who submit a scientifically sound proposal may request access to the de-identified dataset for academic and non-commercial use. Requests should be submitted to the corresponding author via email. Access will be granted following institutional and ethical approval through a secure data-sharing process.

Locations

TU (1)