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The Emotion Regulation, Trait Anger and Anger Expression Styles in Bruxism: A Cross-Sectional Study Among Dental Patients

Year 2025, Volume: 16 Issue: 2, 234 - 242, 18.08.2025
https://doi.org/10.22312/sdusbed.1492668

Abstract

Objective: This study aimed to investigate emotion regulation, trait anger, and anger expression styles in Bruxism
Materials and Methods: This cross-sectional study was conducted between December 2023 and March 2024, where 181 dental patients were recruited. Sociodemographic Information Form, Difficulties of Emotion Regulation Scale (DERS), and The State-Trait Anger Inventory (STAXI) were used as self-reported data collection tools. Ethical approval was obtained. We evaluated the difference between Bruxism and non-bruxism in terms of instruments and predictors of Bruxism.
Results: The outcomes indicated that bruxists had higher trait anger, anger-in, and anger-out scores in terms of non-bruxist (p<0.05). A significantly positive relationship existed between the DERS, trait anger, and anger-in and anger-out (p<0.001). It was found that models including; -DERS-impulse, DERS-clarity, and the presence of Bruxism were statistically found to be significant and identified variables that explained 36% (adjusted) of the variance in the anger-out (p<0.001). Additionally, The interaction between alcohol use and anger-out score demonstrated a 13.1% effect on the likelihood of being diagnosed with Bruxism (R2de Nagelkerke =0,131; p<0.05)
Conclusion: This study underscores the psychosomatic sides of Bruxism and its association with psychological predictors.

Project Number

-

References

  • 1. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45(11):837-844. doi: 10.1111/joor.12663.
  • 2. De Oliveira DD, Brum-Júnior J, Soares L, Cerqueira W, Costa I, Oliveira E, et al. Relationship between stress and bruxism among university students: a cross-sectional study. Rev Estomatol. 2021;29(2). doi: 10.25100/re.v29i1.11071.
  • 3. Erdil D, Bagis N, Eren H, Camgoz M, Orhan K. Evaluation of changes in depression levels of bruxism patients treated with botulinum Toxin-A. J Adv Oral Res. 2021;12(2):200-205. doi:10.1177/23202068211006554.
  • 4. Osses-Anguita ÁE, Sánchez-Sánchez T, Soto-Goñi XA, García-González M, Alén Fariñas F, Cid-Verdejo R, et al. Awake and sleep bruxism prevalence and their associated psychological factors in first-year university students: a pre-mid-post COVID-19 pandemic comparison. Int J Environ Res Public Health. 2023;20(3):2452. doi: 10.3390/ijerph20032452.
  • 5. Soto-Goñi XA, Alen F, Buiza-González L, Marcolino-Cruz D, Sánchez-Sánchez T, Ardizone-García I, et al. Adaptive stress coping in awake bruxism. Front Neurol. 2020;11:564431. doi: 10.3389/fneur.2020.564431.
  • 6. Pejkovska-Shahpaska B, Kapuševska B, Nataša S. Application of night dentures during prosthetic rehabilitation in a patient with bruxism: A case study. Acta Stomatol Naissi. 2018;34(77):1804-1812. doi: 10.5937/asn1877804p.
  • 7. Gouw S, de Wijer A, Bronkhorst EM, Kalaykova SI, Creugers NH. Association between self‐reported bruxism and anger and frustration. J Oral Rehabil. 2019;46(2):101-108. doi: 10.1111/joor.12727.
  • 8. Molina OF, Santos ZC, Sobreiro MA, Cano ML. Anger held inward, aggressive dream content in craniomandibular disorders and bruxers. Rev Neurocienc. 2015;23(4):522-529. doi: 10.4181/RNC.2015.23.04.1088.08p.
  • 9. Goldstein G, DeSantis L, Goodacre C. Bruxism: best evidence consensus statement. J Prosthodont. 2021;30(S1):91-101. doi: 10.1111/jopr.13308.
  • 10. Karababa A. The relationship between trait anger and loneliness among early adolescents: The moderating role of emotion regulation. Pers Individ Dif. 2020;159:109856. doi: 10.1016/j.paid.2020.109856.
  • 11. Ham EM, You MJ. Role of irrational beliefs and anger rumination on nurses’ anger expression styles. Workplace Health Saf. 2018;66(5):223-232. doi: 10.1177/2165079917737090.
  • 12. Özer AK. Sürekli öfke (sl-öfke) ve öfke ifade tarzı (öfke-tarz) ölçeklerinin ön çalışması. Turk Psikoloji Dergisi. 1994;9(31):26-35.
  • 13. Peña-Sarrionandia A, Mikolajczak M, Gross JJ. Integrating emotion regulation and emotional intelligence traditions: a meta-analysis. Front Psychol. 2015;6. doi: 10.3389/fpsyg.2015.00160.
  • 14. Te Brinke LW, Schuiringa HD, Matthys W. Emotion regulation and angry mood among adolescents with externalizing problems and intellectual disabilities. Res Dev Disabil. 2021;109:103833. doi: 10.1016/j.ridd.2020.103833.
  • 15. Smardz J, Martynowicz H, Wojakowska A, Michalek-Zrabkowska M, Mazur G, Wieckiewicz M. Correlation between Sleep Bruxism, Stress, and Depression—A Polysomnographic Study. J Clin Med. 2019;8(9):1344. doi: 10.3390/jcm8091344.
  • 16. Yap AUJ, Chua A. Sleep bruxism: current knowledge and contemporary management. J Conserv Dent. 2016;19(5):383. doi: 10.4103/0972-0707.190007.
  • 17. Goulart AC, Arap AM, Bufarah HB, Bismarchi D, Rienzo M, Syllos DH, et al. Anxiety, depression, and anger in bruxism: a cross-sectional study among adult attendees of a preventive center. Psychiatry Res. 2021;299:113844. doi: 10.1016/j.psychres.2021.113844.
  • 18. Gratz KL, Roemer L. Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess. 2004;26(1):41-54. doi: 10.1023/b.0000007455.08539.94.
  • 19. Rugancı RN, Gençöz T. Psychometric properties of a Turkish version of the difficulties in emotion regulation scale. J Clin Psychol. 2010;66(4):442-455. doi: 10.1002/jclp.20665.
  • 20. Spielberger CD, Reheiser EC. Assessment of Emotions: Anxiety, Anger, Depression, and Curiosity. Appl Psychol Health Well-Being. 2009;1(3):271-302. doi: 10.1111/j.1758-0854.2009.01017.x.
  • 21. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013;27(2):99-110. doi: 10.11607/jop.921.
  • 22. Amalia R, Arifin R, Dwinta Sari G. The relationship between anxiety and bruxism in adults. Dentin. 2023;7(1). doi: 10.20527/dentin.v7i1.8329.
  • 23. Kinalski M, Cadermatori MG, Horta BL, Correa MB, Demarco FF, Pereira-Cenci T. Common mental disorders and bruxism in adults: a birth cohort study. J Dent. 2019;83:27-32. doi: 10.1016/j.jdent.2019.02.003.
  • 24. Kreibig SD, Ten Brink M, Mehta A, Talmon A, Zhang JX, Brown AS, et al. The role of emotion regulation, affect, and sleep in individuals with sleep bruxism and those without: Protocol for a remote longitudinal observational study. JMIR Res Protoc. 2023;12(1). doi: 10.2196/41719.
  • 25. Momeñe J, Estévez A, Herrero M, Griffiths MD, Olave L, Iruarrizaga I. Emotional regulation and body dissatisfaction: the mediating role of anger in young adult women. Front Psychiatry. 2023;14. doi: 10.3389/fpsyt.2023.1221513.
  • 26. Ding Y, Zhao M, Li Z, Xia B, Atutova Z, Kobylkin D. Impact of education for sustainable development on cognition, emotion, and behavior in protected areas. Int J Environ Res Public Health. 2022;19(15):9769. doi: 10.3390/ijerph19159769.
  • 27. Brancher LC, Cademartori MG, Jansen K, da Silva RA, Bach S, Reyes A, et al. Social, emotional, and behavioral problems and parent-reported sleep bruxism in schoolchildren. J Am Dent Assoc. 2020;151(5):327-333.
  • 28. Partoiy Ziraki F, Hassan T. Investigating the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. Int J Clin Med. 2017;8(4):277-292. doi: 10.4236/ijcm.2017.84027.
  • 29. Chin WC, Huang YS, Chou YH, Wang CH, Chen KT, Hsu JF, et al. Subjective and objective assessments of sleep problems in children with attention-deficit hyperactivity disorder and autism spectrum disorder. Pediatrics & Neonatology. 2023.
  • 30. Hesser H, Axelsson S, Bäcke V, Engstrand J, Gustafsson T, Holmgren E, Jeppsson U, Pollack M, Nordén K, Rosenqvist D, Andersson G. Preventing intimate partner violence via the Internet: A randomized controlled trial of emotion-regulation and conflict-management training for individuals with aggression problems. Clin Psychol Psychother. 2017;24(5):1163-1177. doi: 10.1002/cpp.2082.
  • 31. Miletic A, Lazic Z, Todorovic A, Djordjevic I, Popovic D, Lazic V. Stress assessment in patients with clinically diagnosed sleep bruxism. Vojnosanit Pregl. 2018;75(10):1014-1019. doi: 10.2298/vsp160902029m.
  • 32. Martynowicz H, Gac P, Brzecka A, Poreba R, Wojakowska A, Mazur G, Smardz J, Wieckiewicz M. The relationship between sleep bruxism and obstructive sleep apnea based on polysomnographic findings. J Clin Med. 2019;8(10):1653. doi: 10.3390/jcm8101653.
  • 33. Mohapatra A, Choudhury GK, Panda S, Dhar U. Current concept of bruxism and its treatment options. Indian J Forensic Med Toxicol. 2020;14(4):8221-8226. doi: 10.37506/ijfmt.v14i4.12960.
  • 34. Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93(1):19-26. doi: 10.1177/0022034513504782.
  • 35. Mohapatra A, Choudhury GK, Panda S, Dhar U. Current concept of bruxism and its treatment options. Indian J Forensic Med Toxicol. 2020;14(4):8221-8226. doi: 10.37506/ijfmt.v14i4.12960.
  • 36. Kardeş E, Kardeş S. Google searches for bruxism, teeth grinding, and teeth clenching during the COVID-19 pandemic. J Orofac Orthop. 2022;83(6):1-6. doi: 10.1007/s00056-021-00315.

Bruksizmde Duygu Düzenleme, Sürekli Öfke ve Öfke İfade Tarzlarının İncelenmesi: Diş Kliniğine Başvuran Hastalarla Kesitsel Bir Çalışma

Year 2025, Volume: 16 Issue: 2, 234 - 242, 18.08.2025
https://doi.org/10.22312/sdusbed.1492668

Abstract

Amaç: Bu çalışma, bruksizmde duygu düzenleme, sürekli öfke ve öfke ifade tarzlarının incelenmesi amaçlamıştır.

Materyal ve Metot: Araştırma, Aralık 2023 ve Mart 2024 tarihleri arasında diş kliniğine başvuran 181 kişinin katılımıyla gerçekleşmiştir. Sosyodemografik Bilgi Formu, Duygu Düzenleme Güçlüğü Ölçeği (DDGÖ) ve Durumluk-Sürekli Öfke Ölçeği (DSÖÖ) veri toplama araçları olarak kullanılmıştır. Araştırmanın etik onayı alınmıştır. Araştırmanı sonuçları Bruksizm ve Bruksizm olmayanlar arasındaki fark ve bruksizmin yordayıcıları açısından değerlendirilmiştir.

Bulgular: Sürekli öfke, içe-öfke ve dışa-öfke puanları, Bruksizm tanısı olanlarda daha yüksek bulunmuştur (p<0.05). DDGÖ ile sürekli öfke, içe-öfke ve dışa-öfke puanları arasında pozitif yönde anlamlı bir ilişki vardır (p<0.001). DDGÖ-dürtü, DDGÖ-açıklık ve Bruksizmi içeren model, dışa-öfkenin %36'sını açıklamıştır (p<0.001). Alkol kullanımı ile dışa-öfkenin birlikteliği Bruksizm tanısı alma üzerinde %13,1'lik bir etki göstermiştir (R2de Nagelkerke =0,131; p<0,05).

Sonuç: Bu çalışma bruksizmin psikosomatik yönlerini ve psikolojik belirleyicilerle olan ilişkisini vurgulamaktadır.

Project Number

-

References

  • 1. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45(11):837-844. doi: 10.1111/joor.12663.
  • 2. De Oliveira DD, Brum-Júnior J, Soares L, Cerqueira W, Costa I, Oliveira E, et al. Relationship between stress and bruxism among university students: a cross-sectional study. Rev Estomatol. 2021;29(2). doi: 10.25100/re.v29i1.11071.
  • 3. Erdil D, Bagis N, Eren H, Camgoz M, Orhan K. Evaluation of changes in depression levels of bruxism patients treated with botulinum Toxin-A. J Adv Oral Res. 2021;12(2):200-205. doi:10.1177/23202068211006554.
  • 4. Osses-Anguita ÁE, Sánchez-Sánchez T, Soto-Goñi XA, García-González M, Alén Fariñas F, Cid-Verdejo R, et al. Awake and sleep bruxism prevalence and their associated psychological factors in first-year university students: a pre-mid-post COVID-19 pandemic comparison. Int J Environ Res Public Health. 2023;20(3):2452. doi: 10.3390/ijerph20032452.
  • 5. Soto-Goñi XA, Alen F, Buiza-González L, Marcolino-Cruz D, Sánchez-Sánchez T, Ardizone-García I, et al. Adaptive stress coping in awake bruxism. Front Neurol. 2020;11:564431. doi: 10.3389/fneur.2020.564431.
  • 6. Pejkovska-Shahpaska B, Kapuševska B, Nataša S. Application of night dentures during prosthetic rehabilitation in a patient with bruxism: A case study. Acta Stomatol Naissi. 2018;34(77):1804-1812. doi: 10.5937/asn1877804p.
  • 7. Gouw S, de Wijer A, Bronkhorst EM, Kalaykova SI, Creugers NH. Association between self‐reported bruxism and anger and frustration. J Oral Rehabil. 2019;46(2):101-108. doi: 10.1111/joor.12727.
  • 8. Molina OF, Santos ZC, Sobreiro MA, Cano ML. Anger held inward, aggressive dream content in craniomandibular disorders and bruxers. Rev Neurocienc. 2015;23(4):522-529. doi: 10.4181/RNC.2015.23.04.1088.08p.
  • 9. Goldstein G, DeSantis L, Goodacre C. Bruxism: best evidence consensus statement. J Prosthodont. 2021;30(S1):91-101. doi: 10.1111/jopr.13308.
  • 10. Karababa A. The relationship between trait anger and loneliness among early adolescents: The moderating role of emotion regulation. Pers Individ Dif. 2020;159:109856. doi: 10.1016/j.paid.2020.109856.
  • 11. Ham EM, You MJ. Role of irrational beliefs and anger rumination on nurses’ anger expression styles. Workplace Health Saf. 2018;66(5):223-232. doi: 10.1177/2165079917737090.
  • 12. Özer AK. Sürekli öfke (sl-öfke) ve öfke ifade tarzı (öfke-tarz) ölçeklerinin ön çalışması. Turk Psikoloji Dergisi. 1994;9(31):26-35.
  • 13. Peña-Sarrionandia A, Mikolajczak M, Gross JJ. Integrating emotion regulation and emotional intelligence traditions: a meta-analysis. Front Psychol. 2015;6. doi: 10.3389/fpsyg.2015.00160.
  • 14. Te Brinke LW, Schuiringa HD, Matthys W. Emotion regulation and angry mood among adolescents with externalizing problems and intellectual disabilities. Res Dev Disabil. 2021;109:103833. doi: 10.1016/j.ridd.2020.103833.
  • 15. Smardz J, Martynowicz H, Wojakowska A, Michalek-Zrabkowska M, Mazur G, Wieckiewicz M. Correlation between Sleep Bruxism, Stress, and Depression—A Polysomnographic Study. J Clin Med. 2019;8(9):1344. doi: 10.3390/jcm8091344.
  • 16. Yap AUJ, Chua A. Sleep bruxism: current knowledge and contemporary management. J Conserv Dent. 2016;19(5):383. doi: 10.4103/0972-0707.190007.
  • 17. Goulart AC, Arap AM, Bufarah HB, Bismarchi D, Rienzo M, Syllos DH, et al. Anxiety, depression, and anger in bruxism: a cross-sectional study among adult attendees of a preventive center. Psychiatry Res. 2021;299:113844. doi: 10.1016/j.psychres.2021.113844.
  • 18. Gratz KL, Roemer L. Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess. 2004;26(1):41-54. doi: 10.1023/b.0000007455.08539.94.
  • 19. Rugancı RN, Gençöz T. Psychometric properties of a Turkish version of the difficulties in emotion regulation scale. J Clin Psychol. 2010;66(4):442-455. doi: 10.1002/jclp.20665.
  • 20. Spielberger CD, Reheiser EC. Assessment of Emotions: Anxiety, Anger, Depression, and Curiosity. Appl Psychol Health Well-Being. 2009;1(3):271-302. doi: 10.1111/j.1758-0854.2009.01017.x.
  • 21. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013;27(2):99-110. doi: 10.11607/jop.921.
  • 22. Amalia R, Arifin R, Dwinta Sari G. The relationship between anxiety and bruxism in adults. Dentin. 2023;7(1). doi: 10.20527/dentin.v7i1.8329.
  • 23. Kinalski M, Cadermatori MG, Horta BL, Correa MB, Demarco FF, Pereira-Cenci T. Common mental disorders and bruxism in adults: a birth cohort study. J Dent. 2019;83:27-32. doi: 10.1016/j.jdent.2019.02.003.
  • 24. Kreibig SD, Ten Brink M, Mehta A, Talmon A, Zhang JX, Brown AS, et al. The role of emotion regulation, affect, and sleep in individuals with sleep bruxism and those without: Protocol for a remote longitudinal observational study. JMIR Res Protoc. 2023;12(1). doi: 10.2196/41719.
  • 25. Momeñe J, Estévez A, Herrero M, Griffiths MD, Olave L, Iruarrizaga I. Emotional regulation and body dissatisfaction: the mediating role of anger in young adult women. Front Psychiatry. 2023;14. doi: 10.3389/fpsyt.2023.1221513.
  • 26. Ding Y, Zhao M, Li Z, Xia B, Atutova Z, Kobylkin D. Impact of education for sustainable development on cognition, emotion, and behavior in protected areas. Int J Environ Res Public Health. 2022;19(15):9769. doi: 10.3390/ijerph19159769.
  • 27. Brancher LC, Cademartori MG, Jansen K, da Silva RA, Bach S, Reyes A, et al. Social, emotional, and behavioral problems and parent-reported sleep bruxism in schoolchildren. J Am Dent Assoc. 2020;151(5):327-333.
  • 28. Partoiy Ziraki F, Hassan T. Investigating the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. Int J Clin Med. 2017;8(4):277-292. doi: 10.4236/ijcm.2017.84027.
  • 29. Chin WC, Huang YS, Chou YH, Wang CH, Chen KT, Hsu JF, et al. Subjective and objective assessments of sleep problems in children with attention-deficit hyperactivity disorder and autism spectrum disorder. Pediatrics & Neonatology. 2023.
  • 30. Hesser H, Axelsson S, Bäcke V, Engstrand J, Gustafsson T, Holmgren E, Jeppsson U, Pollack M, Nordén K, Rosenqvist D, Andersson G. Preventing intimate partner violence via the Internet: A randomized controlled trial of emotion-regulation and conflict-management training for individuals with aggression problems. Clin Psychol Psychother. 2017;24(5):1163-1177. doi: 10.1002/cpp.2082.
  • 31. Miletic A, Lazic Z, Todorovic A, Djordjevic I, Popovic D, Lazic V. Stress assessment in patients with clinically diagnosed sleep bruxism. Vojnosanit Pregl. 2018;75(10):1014-1019. doi: 10.2298/vsp160902029m.
  • 32. Martynowicz H, Gac P, Brzecka A, Poreba R, Wojakowska A, Mazur G, Smardz J, Wieckiewicz M. The relationship between sleep bruxism and obstructive sleep apnea based on polysomnographic findings. J Clin Med. 2019;8(10):1653. doi: 10.3390/jcm8101653.
  • 33. Mohapatra A, Choudhury GK, Panda S, Dhar U. Current concept of bruxism and its treatment options. Indian J Forensic Med Toxicol. 2020;14(4):8221-8226. doi: 10.37506/ijfmt.v14i4.12960.
  • 34. Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93(1):19-26. doi: 10.1177/0022034513504782.
  • 35. Mohapatra A, Choudhury GK, Panda S, Dhar U. Current concept of bruxism and its treatment options. Indian J Forensic Med Toxicol. 2020;14(4):8221-8226. doi: 10.37506/ijfmt.v14i4.12960.
  • 36. Kardeş E, Kardeş S. Google searches for bruxism, teeth grinding, and teeth clenching during the COVID-19 pandemic. J Orofac Orthop. 2022;83(6):1-6. doi: 10.1007/s00056-021-00315.
There are 36 citations in total.

Details

Primary Language English
Subjects Psychiatry, Mental Health Services
Journal Section Araştırma Articlesi
Authors

Seda Karakaya Çataldaş 0000-0002-1724-6360

Reyhan Doğan 0000-0002-5392-1175

Project Number -
Publication Date August 18, 2025
Submission Date May 31, 2024
Acceptance Date March 13, 2025
Published in Issue Year 2025 Volume: 16 Issue: 2

Cite

Vancouver Karakaya Çataldaş S, Doğan R. The Emotion Regulation, Trait Anger and Anger Expression Styles in Bruxism: A Cross-Sectional Study Among Dental Patients. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2025;16(2):234-42.

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