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This study investigated the association between TMD diagnoses, hypervigilance, and kinesiophobia, and whether these variables could differentiate distinct clinical profiles across painful and non-painful conditions. In this multicenter cross-sectional observational study, 862 adults aged 18 to 50 years from Brazil, Chile, and Portugal were classified as controls, non-painful TMD, or painful TMD. Diagnoses were established using the Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD). Hypervigilance and kinesiophobia were assessed using the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Tampa Scale for Kinesiophobia for TMD (TSK\/TMD). Statistical analyses included factor analysis of mixed data, hierarchical clustering on principal components, and partial least squares discriminant analysis, followed by multivariate and regression analyses to assess potential associations between psychosocial variables and TMD diagnoses. Among 862 participants (312 controls, 550 TMD), kinesiophobia and hypervigilance increased across groups, with the highest levels in painful TMD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Unsupervised clustering identified three distinct profiles aligned with clinical presentation: controls with low psychological burden, non-painful TMD with intermediate levels, and painful TMD with elevated kinesiophobia and hypervigilance. Multivariate analyses showed associations of psychosocial variables with TMD diagnoses, with kinesiophobia consistently driving group differences, while age, gender, and pain vigilance had a moderate influence. Among TMD subgroups, joint pain was associated with higher pain vigilance and muscular TMD with higher kinesiophobia, suggesting greater clinical complexity. Higher levels of hypervigilance and kinesiophobia were associated with painful and clinical more complex TMD profiles.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-60271-w","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:29:17Z","timestamp":1782750557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypervigilance and kinesiophobia characterize distinct exploratory data-driven profiles of temporomandibular disorders"],"prefix":"10.1038","volume":"16","author":[{"given":"Adriana Battisti","family":"Archer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Davi","family":"da Silva Mello Noel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Salinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"De Nordenflycht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Miguel Teixeira Carvas","family":"Cebola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tassia Tillemont","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"de Souza Tesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thayanne Brasil Barbosa","family":"Calcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz Dulcineia Mendes","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Barhanko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Grigoriadis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyanne Medina","family":"Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-342X","authenticated-orcid":false,"given":"Giancarlo","family":"De la Torre Canales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"issue":"4","key":"60271_CR1","doi-asserted-by":"publisher","first-page":"e0294830","DOI":"10.1371\/journal.pone.0294830","volume":"19","author":"M Dunn","year":"2024","unstructured":"Dunn, M., Rushton, A. B., Mistry, J., Soundy, A. & Heneghan, N. R. The biopsychosocial factors associated with development of chronic musculoskeletal pain. An umbrella review and meta-analysis of observational systematic reviews. PloS one. 19 (4), e0294830. https:\/\/doi.org\/10.1371\/journal.pone.0294830 (2024).","journal-title":"PloS one"},{"issue":"3","key":"60271_CR2","doi-asserted-by":"publisher","first-page":"e1160","DOI":"10.1097\/PR9.0000000000001160","volume":"9","author":"WM Hooten","year":"2024","unstructured":"Hooten, W. M. et al. Integrated pain care models and the importance of aligning stakeholder values. Pain Rep. 9 (3), e1160. https:\/\/doi.org\/10.1097\/PR9.0000000000001160 (2024).","journal-title":"Pain Rep."},{"issue":"8","key":"60271_CR3","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1097\/j.pain.0000000000002885","volume":"164","author":"AN Abudoush","year":"2023","unstructured":"Abudoush, A. N. et al. 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Physiother Theory Pract. 41 (1), 12\u201327. https:\/\/doi.org\/10.1080\/09593985.2024.2316305 (2025).","journal-title":"Physiother Theory Pract."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60271-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60271-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60271-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:50:25Z","timestamp":1782751825000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60271-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["60271"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-60271-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"16 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was approved by the respective institutional research ethics committees of Andres Bello University, Chile: #56-2024; Egas Moniz School of Health and Science, Portugal: #1273; CUF TEJO Hospital, Portugal: #33956737\/2023 and Centro Universit\u00e1rio Arthur S\u00e1 Earp Neto (UNIFASE), Brazil: 6.826.183\/2024 and conducted in accordance with the principles of the Declaration of Helsinki. All participants were informed about the aims of the study and provided written informed consent prior to participation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"19786"}}