Author ORCID Identifier

https://orcid.org/0000-0003-0074-3640

Semester

Summer

Date of Graduation

2025

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Daniel W. McNeil

Committee Co-Chair

Amy Fiske

Committee Member

Christa Lilly

Committee Member

Shari A. Steinman

Committee Member

Roberta Pileggi

Abstract

Studies of interpretation bias related to pain have consistently shown that patients with pain are more likely to interpret ambiguous stimuli as related to pain than healthy control participants. This phenomenon is associated with pain and related outcomes, including depression, anxiety, and avoidance behaviors, suggesting a potential target in pain management. This study aimed to examine whether the association between interpretation bias, pain, and emotional status can be replicated in a dental care population. The relation of interpretation bias to pain experience was tested in a naturalistic anxiety and pain-provoking setting (i.e., root canal treatment, RCT). A total of 82 participants were recruited from the Endodontics Clinic at the University of Florida College of Dentistry. Participants completed questionnaires assessing their pain, depression, anxiety, fear of pain, dental avoidance, dental fear/anxiety, and interpretation bias. In addition, participants completed assessments about their threat expectations about the upcoming RCT and pain intensity during the RCT. Pain-related interpretation bias was positively associated with negative emotions, including fear of pain, depression, and anxiety. Although interpretation bias related to pain was not significantly related to threat expectation and pain intensity during the RCT, dental fear/anxiety, which could be indirectly affected by interpretation bias, was found to influence RCT-related pain experiences. These results imply that interpretation bias may play a role in patients’ experience during dental procedures, and that interventions on interpretation bias related to pain in dental care settings have the potential to address dental care-related stress and avoidance behaviors.

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