The modulating effect of bruxism as a form of suppressed hostility on depression in a selected population of tension type headache (ttha) and craniomandibular disorders (cmds) individuals


  • Omar Franklin Molina Post Doctoral in Orofacial Pain (Harvard University), MDS, PA, Professor of Orofacial Pain, School of Dentistry, UNIRG-TO.
  • Marcus Sobreira Peixoto MDS, Ph.D in Orthodontics, UNESP, Professor of Orthodontics, Dean UNIRG-TO.
  • Raphael Navarro Aquilino MDS, Ph.D (Radiology-UNICAMP), Professor of Radiology, UNIRG-TO.
  • Rise Rank MDS, Dean, School of Dentistry, UNIRG, Tocantins.



Craniomandibular disorders Tension-type headache Bruxism Depression


AIMS: explore the hypothesis that bruxism and depression are forms of suppressed hostility in individuals presenting Craniomandibular Disorders (CMDs) and Tension-type Headache (TTHa). METHODS: We evaluated a group of 100 Craniomandibular Disorders and Tension-Type Headache individuals, a group of 38 CMDs and Facial Pain individuals and a group of 23 No Craniomandibular Disorders No Facial Pain individuals. Clinical examination, questionnaires, history of signs and symptoms, the Beck Depression Inventory (BDI) and the Cook-Medley Inventory (HO) were used to gather data. RESULTS: The frequency of Tension Type Headache was about 43.5% in the group of 230 Craniomandibular Disorder patients. Mean scores in hostility were 19.0, 17.7 and 17.2 in the groups presenting Tension-Type Headache and CMDs, CMDs and Facial Pain and No CMDs no Pain, respectively. Mean scores in depression were about 12.0, 9.1 and 5.7 respectively in the same groups. Mean scores in bruxism were about 12.9, 8.2 and 6.8, respectively in the same groups. The strongest correlation between bruxism and depression were observed in the TTHa group (r=0.4, p<0.0001) and in the Non CMD Non Pain group (r=0.48, p<0.02). CONCLUSION: Depression is a better indicator of hostility in subgroups presenting TTHa. Scores in bruxism and depression as a form of suppressed hostility are higher in CMDs and TTHa individuals than in controls without TTHa. Because scores in bruxism were higher in TTHa and CMDs individuals, there is a strong and positive association between bruxism and TTHa in individuals with concomitant Craniomandibular disorders.


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Millea, P.; Brodie, J.J. Tension- type headache. American Family Physicians, v.66, p. 804-805, 2002.

Silberstein, S. D. Tension-type headaches. Headache: The Journal of Head and Face Pain, v.34, p.S2-S7, 2005.

Campbell, D. G. Psychosomatic mechanisms in s oral disease. American Journal of Orthodontics and Oral Surgery, v. 31, p. 440, 1945.

Kim H.S.; Chung S.C.; Kim, Y.K.; Lee, S.W. Pain-pressure thresholds in the head and neck region of episodic tension-type headache patients. Journal of Orofacial Pain,.v.9, p.357-364, 1995.

American College of Physicians Internet 2009, p.1-2.

Burns, J.W.; Bruehl, S.; Quartana, P. Anger management style and hostility among patients with chronic pain. Psychosomatic Medicine, v.68, p.786-793, 2006.

Engel G. Psychogenic pain and the pain prone patient. American Journal of Medicine, v.26, p.899-918, 1959.

Sjegaard, G.; Lundberg, U.; Kudefors, R. The role of muscle activity and mental load in the development of pain and degenerative processes f the muscle cell during computer work. European Journal of Applied Physiology, v.83, p. 99-105, 2000.

Fields, H.L. Pain. 1. Ed. New York: Raven Press, 1987.

Finney, M.; Stoney, C.M.; Engebretson, T.O. Hostility and anger expression in African American and European American me is associated with cardiovascular and lipid reactivity. Psychophysiology, v.39, p.340-349, 2002;

Nicholson, R.A,; Houle, T.T.; Rhudy, J.; Norton, P. Psychological risk factors in headache. Headache, v. 47, p.413-426, 2007.

Molina, O.F.; dos Santos, J.; Nelson, S.; Grossman, E. Prevalence of modalities of headache and bruxism among patients with cranimandibular disorders. Journal of Craniomandibular Practice, v. 15, p.314-325, 1997.

Molina, O.F.; Peixoto, M.G.; Santos, Z.C.; Penoni, J.D.; Aquilino, R.N.; Sobreiro, M.A. Bruxism as a mechanism subserving hysteria: A new theory. Revista Neurociencias, v.16, p.262-268, 2008.

Ad Hoc Committee on Classification of Headaches. Classification of Headache. Journal of American Medical Association, v.179, p.717-718, 1962.

American Headache Society WWW.

Arena, J.G.; Bruno, G.M.; Rozantine, G.S.; Meador, K.J. A comparison of tension headache sufferers and nonpain controls on the state-trait anger expression inventory. Applied Psychophysiology and Biofeedback, v.22, p.209-214, 1997.

Bridewell, W.B.; Chang, E.C. Distinguishing between anxiety, depression and hostility: Relationships in anger in, anger out and anger control. Personality and Individual Differences, v.22, p. 587-590, 1997.

Materazzo, F.; Cathcart, S.; Pritchard, D. Anger, depression and coping interactions in headache activity and adjustment. A controlled study. Journal of Psychosomatic Research, v.49, p.69-75, 2000.

Hatch, J.P.; Schoenfeld, L.S.; Boutros, N.N.; Seleshi, E.; Moorte, P.J.; Cyr-Provost, M. Anger and hostility in tension-type headache. Headache, v. 31, p. 302-304, 1991.

Wade, J.B.; Price, D.; Hammer, R.M.; Schwartz, S . M.; Hart, R.P. An emotional component analysis of chronic pain. Pain, v. 40, p.303-310, 1990.

Perozzo, P.; Savi, L.; Castelli, L.; Valfré, W.; Lo Giudice, R.; Gentile, S.; Raineiro, I.; Pinessi, L. Anger and emotional distress in patients with migraine and tension type headache. The Journal of Headache and Pain, v.6, p.392-399, 2005.

Battistuta, S.; Aliverti, R.; Montic, M.; Zin, M.; Carrozzi, M. Chronic tension-type headache in adolescents. Clinical and psychological characteristics analyzed through self-and parent-report questionnaires. J Pediatric Psychology, v.34, p.697-706, 2009.

Thomas, S.; Williams, R.L. Perceived stress, trait anger, modes of anger expression, and health status of college men and women. Nursing Research v.40, p.303-307, 1991

Venable, V.; Carlsson, C.R.; Wilson, J. The role of anger and depression in recurrent headaches. Headache, v. 41, p. 21-30, 2001.

Molina, O.F.; dos Santos, J. Hostility in TMD/bruxing patients and controls: A clinical comparison study and preliminary results. Journal of Craniomandibular Practice, v.20, p. 282-288, 2002.

Ware, J.C.; Rugh, J.D. Destructive bruxism: Sleep stage relationships. Sleep, v. 11, p. 172-181, 1988.

Holroyd, K.A.; Stensland, M.; Lipchik, G.L.; Hills, K.R.; O´Donnell, F.S.; Cordingley, G. Psychosocial correlates and impact of chronic tension-type headache. Headache, v. 40, p. 3-16, 2000.

Mitsikostas, D.D.; Thomas, A.M. Comorbidity of headache and depressive disorders. Cephalalgia, v. 19, p. 211-217, 1999.

Kreisberg, M.K. Headache as a symptom of craniomandibular disorders I: Pathophysiology. Journal of Craniomand Practice, v.4, p.134-141, 1986. 1986;

Ribeiro, C.A.; Esperança, P.; Souza, L. Cefaléias tipo tensão: fisiopatologia, clínica e tratamento. Revista Portuguesa de Clínica Geral, v.22, p. 483-490, 2006.




Como Citar

MOLINA, O. F.; PEIXOTO, M. S.; AQUILINO, R. N.; RANK, R. The modulating effect of bruxism as a form of suppressed hostility on depression in a selected population of tension type headache (ttha) and craniomandibular disorders (cmds) individuals. Cadernos UniFOA, Volta Redonda, v. 6, n. 15, p. 91–100, 2017. DOI: 10.47385/cadunifoa.v6.n15.1045. Disponível em: Acesso em: 4 jul. 2022.



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