Can galvanic skin conductance be used as an objective indicator of children's anxiety in the dental setting?

Ebrahim Najafpour, Naser Asl-Aminabadi, Sara Nuroloyuni, Zahra Jamali, Sajjad Shirazi, Ebrahim Najafpour, Naser Asl-Aminabadi, Sara Nuroloyuni, Zahra Jamali, Sajjad Shirazi

Abstract

Background: Assessment of procedural distress is essential at assisting children during invasive dental treatments. This study aimed to determine the validity and reliability of galvanic skin response as a measure for assessment of dental anxiety in children.

Material and methods: 151 children, aged 5-7 years, participated in this study. Similar dental treatments were rendered to all subjects. At the beginning and end of the session, modified child dental anxiety scale (MCDAS), clinical anxiety rating scale (CARS) and galvanic skin response (GSR) were used to determine children's anxiety.

Results: GSR was significantly correlated with both MCDAS (rs=0.62, p=0.02) and CARS (rs=0.44, p=0.032). The correlation between MCDAS and CARS was also significant (rs = 0.9, P<0.001). Anxiety decreased during the session in both GSR (rs=0.52, p=0.001) and MCDAS scales (rs=0.77, p=0.001). CARS also showed a reduction between the initial and second assessment, but it was not statistically significant (rs=0.12, P=0.36).

Conclusions: The findings suggest that GSR is a reliable and valid measure for assessment of children's dental anxiety in the clinical context. GSR may help to identify clinically anxious children before dental treatment to provide appropriate interventions. Key words:Dental anxiety, reliability, validity, galvanic skin response.

Conflict of interest statement

Conflict of interest statement:The authors declared that they had no conflict of interest.

Figures

Figure 1
Figure 1
Faces version of the Modified Child Dental Anxiety Scale (MCDAS).

References

    1. Aminabadi NA, Najafpour E, Aghaee S, Sighari Deljavan A, Jamali Z, Shirazi S. Use of general anaesthesia in paediatric dentistry: barriers to discriminate between true and false cases. Eur Arch Paediatr Dent. 2016;17:89–95.
    1. Holmes RD, Girdler NM. A study to assess the validity of clinical judgement in determining paediatric dental anxiety and related outcomes of management. Int J Paediatr Dent. 2005;15:169–76.
    1. Aminabadi NA, Sohrabi A, Oskouei SG, Aghaee S, Jamali Z, Ghojazadeh M. Design and preliminary validation of the verbal skill scale in the dental setting: an anxiety scale for children. Pediatr Dent. 2013;35:E43–8.
    1. Mirzakouchaki B, Shirazi S, Sharghi R, Shirazi S. Assessment of Factors Affecting Adolescent Patients' Compliance with Hawley and Vacuum Formed Retainers. J Clin Diagn Res. 2016;10:Zc24–7.
    1. von Baeyer CL. Children's self-reports of pain intensity: scale selection, limitations and interpretation. Pain Res Manag. 2006;11:157–62.
    1. Spence SH. A measure of anxiety symptoms among children. Behav Res Ther. 1998;36:545–66.
    1. Craig KD, McMahon RJ, Morison JD, Zaskow C. Developmental changes in infant pain expression during immunization injections. Soc Sci Med. 1984;19:1331–7.
    1. Arena JG, Blanchard EB, Andrasik F, Cotch PA, Myers PE. Reliability of psychophysiological assessment. Behav Res Ther. 1983;21:447–60.
    1. Tiwari N, Tiwari S, Thakur R, Agrawal N, Shashikiran ND, Singla S. Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response. Contemp Clin Dent. 2015;6:327–31.
    1. Caprara HJ, Eleazer PD, Barfield RD, Chavers S. Objective measurement of patient's dental anxiety by galvanic skin reaction. J Endod. 2003;29:493–6.
    1. Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016;8:35–50.
    1. Margrain TH, Greenland K, Anderson J. Evaluating anxiety in patients attending optometric practice. Ophthalmic Physiol Opt. 2003;23:287–93.
    1. Probst TM, Jiang L. Mitigating Physiological Responses to Layoff Threat: An Experimental Test of the Efficacy of Two Coping Interventions. Int J Environ Res Public Health. 2016;13:pii.E338..
    1. Benjamins C, Schuurs AH, Hoogstraten J. Skin conductance, Marlowe-Crowne defensiveness, and dental anxiety. Percept Mot Skills. 1994;79:611–22.
    1. Asl Aminabadi N, Satrab S, Najafpour E, Samiei M, Jamali Z, Shirazi S. A randomized trial of direct pulp capping in primary molars using MTA compared to 3Mixtatin: a novel pulp capping biomaterial. Int J Paediatr Dent. 2016;26:281–90.
    1. Aminabadi NA, Huang B, Samiei M, Agheli S, Jamali Z, Shirazi S. A Randomized Trial Using 3Mixtatin Compared to MTA in Primary Molars with Inflammatory Root Resorption: A Novel Endodontic Biomaterial. J Clin Pediatr Dent. 2016;40:95–102.
    1. Shirazi S, Kachoei M, Shahvaghar-Asl N, Shirazi S, Sharghi R. Arch width changes in patients with Class II division 1 malocclusion treated with maxillary first premolar extraction and non-extraction method. J Clin Exp Dent. 2016;8:e363–8.
    1. Howard KE, Freeman R. Reliability and validity of a faces version of the Modified Child Dental Anxiety Scale. Int J Paediatr Dent. 2007;17:281–8.
    1. Erfanparast L, Vafaei A, Sohrabi A, Ranjkesh B, Bahadori Z, Pourkazemi M. Impact of Self-concept on Preschoolers' Dental Anxiety and Behavior. J Dent Res Dent Clin Dent Prospects. 2015;9:188–92.
    1. Aminabadi NA, Behroozian A, Talatahari E, Samiei M, Sadigh-Eteghad S, Shirazi S. Does prenatal restraint stress change the craniofacial growth pattern of rat offspring? Eur J Oral Sci. 2016;124:17–25.
    1. Poureslami H, Asl Aminabadi N, Sighari Deljavan A, Erfanparast L, Sohrabi A, Jamali Z. Does Timing of Eruption in First Primary Tooth Correlate with that of First Permanent Tooth? A 9-years Cohort Study. J Dent Res Dent Clin Dent Prospects. 2015;9:79–85.
    1. Venham L, Bengston D, Cipes M. Children's response to sequential dental visits. J Dent Res. 1977;56:454–9.
    1. Aminabadi NA, Najafpour E, Erfanparast L, Jamali Z, Pournaghi-Azar F, Tamjid-Shabestari S. Oral health status, dental anxiety, and behavior-management problems in children with oppositional defiant disorder. Eur J Oral Sci. 2016;124:45–51.
    1. Corah NL, Pantera RE. Controlled study of psychologic stress in a dental procedure. J Dent Res. 1968;47:154–7.
    1. Corah NL. Psychologic stress in a video-simulated dental restoration. J Dent Res. 1969;48:444–7.
    1. Corah NL, Bissell GD, Illig SJ. Effect of perceived control on stress reduction in adult dental patients. J Dent Res. 1978;57:74–6.
    1. Corah NL, Gale EN, Illig SJ. Psychological stress reduction during dental procedures. J Dent Res. 1979;58:1347–51.
    1. El-Sheikh M. Children's skin conductance level and reactivity: are these measures stable over time and across tasks? Dev Psychobiol. 2007;49:180–6.
    1. McManis MH, Bradley MM, Berg WK, Cuthbert BN, Lang PJ. Emotional reactions in children: verbal, physiological, and behavioral responses to affective pictures. Psychophysiology. 2001;38:222–31.
    1. Raadal M, Milgrom P, Weinstein P, Mancl L, Cauce AM. The prevalence of dental anxiety in children from low-income families and its relationship to personality traits. J Dent Res. 1995;74:1439–43.
    1. Buchanan H, Niven N. Validation of a Facial Image Scale to assess child dental anxiety. Int J Paediatr Dent. 2002;12:47–52.
    1. Venables PH, Mitchell DA. The effects of age, sex and time of testing on skin conductance activity. Biol Psychol. 1996;43:87–101.
    1. Hellerud BC, Storm H. Skin conductance and behaviour during sensory stimulation of preterm and term infants. Early Hum Dev. 2002;70:35–46.
    1. Storm H, Fremming A, Odegaard S, Martinsen OG, Morkrid L. The development of a software program for analyzing spontaneous and externally elicited skin conductance changes in infants and adults. Clin Neurophysiol. 2000;111:1889–98.
    1. Rosenberg HM, Katcher AH. Heart rate and physical activity of children during dental treatment. J Dent Res. 1976;55:648–51.
    1. Montagu JD, Coles EM. Mechanism and measurement of the galvanic skin response. Psychol Bull. 1966;65:261–79.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera