{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:59:38Z","timestamp":1775537978773,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Awake bruxism (AB) is closely linked to psychological factors and commonly co\u2010occurs with painful temporomandibular disorders (TMD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the role of anxiety comparing the frequency of AB behaviours, as well as levels of perceived stress, pain catastrophizing and depressive symptoms among patients with painful TMD, categorised by clinical anxiety levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 72 patients diagnosed with painful TMD were enrolled and classified into two groups based on\n                      <jats:italic>T<\/jats:italic>\n                      \u2010scores derived from the Generalised Anxiety Disorder 7\u2010item scale [GAD\u20107]: elevated symptoms of anxiety group (\n                      <jats:italic>T<\/jats:italic>\n                      \u2009\u2265\u200961): 30 and normative anxiety (\n                      <jats:italic>T<\/jats:italic>\n                      \u2009\u2264\u200960): 42.\n                      <jats:italic>T<\/jats:italic>\n                      \u2010score calculations were based on a previously studied pain\u2010free control group. AB behaviours were recorded through Ecological Momentary Assessment (EMA), and participants completed the Perceived Stress Scale [PSS], the Pain Catastrophizing Scale [PCS] and the Patient Health Questionnaire\u20109 [PHQ\u20109], alongside lifestyle assessment. Between\u2010group comparisons and correlation analyses were conducted to evaluate associations between anxiety and clinical, behavioural and psychosocial outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with elevated symptoms of anxiety exhibited higher total AB frequency (89%; 72.12%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.002), particularly increased tooth clenching (26.90%; 13.48%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.016). They also reported significantly higher clinical pain intensity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005), as well as elevated perceived stress (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), higher pain catastrophizing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.032), especially helplessness (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.050) and rumination (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.47) and more severe depressive symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.002). No significant differences were seen between groups in physical activity, social engagement, alcohol drinking or smoking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings underscore that TMD patients with elevated clinical symptoms of anxiety exhibit significantly higher frequencies of AB, specifically tooth clenching, psychological distress and pain intensity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70158","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T09:21:23Z","timestamp":1769592083000},"page":"1009-1017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological Features Associated With Awake Bruxism in Painful\n                    <scp>TMD<\/scp>\n                    : The Role of Anxiety"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5291-4264","authenticated-orcid":false,"given":"Dyanne","family":"Medina Flores","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Bauru School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samilla Pontes","family":"Braga","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Bauru School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-342X","authenticated-orcid":false,"given":"Giancarlo","family":"De La Torre Canales","sequence":"additional","affiliation":[{"name":"Division of Oral Rehabilitation, Department of Dental Medicine Karolinska Institutet  Huddinge Sweden"},{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health &amp; Science  Almada Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7805-5672","authenticated-orcid":false,"given":"Juliana","family":"Stuginski\u2010Barbosa","sequence":"additional","affiliation":[{"name":"Bauru Orofacial Pain Group  Bauru SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0413-4658","authenticated-orcid":false,"given":"Paulo C\u00e9sar Rodrigues","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Bauru School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Anxiety. Social Problems and Mental Health","author":"Spielberger C. D.","year":"1987"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13005-025-00522-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/2069716"},{"issue":"6","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1080\/08869634.2016.1163806","article-title":"Cross\u2010Sectional Study of Anxiety Symptoms and Self\u2010Report of Awake and Sleep Bruxism in Female TMD Patients","volume":"34","author":"Tavares L. M.","year":"2016","journal-title":"Cranio: The Journal of Craniomandibular Practice"},{"issue":"3","key":"e_1_2_11_7_1","first-page":"264","article-title":"The Phenotype, Psychotype and Genotype of Bruxism","volume":"8","author":"Cruz\u2010Fierro N.","year":"2018","journal-title":"Biomedical Reports"},{"key":"e_1_2_11_8_1","first-page":"143","volume-title":"Guidelines for Assessment, Diagnosis, and Management","author":"Leeuw R.","year":"2018"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.1277"},{"key":"e_1_2_11_10_1","article-title":"Clusters According to Anxiety Phenotypes Impact on Pain Perception and Muscular Fatigue in Temporomandibular Disorders","volume":"5","author":"Melchior M. d. O.","year":"2019","journal-title":"International Journal of Oral & Dental Health"},{"issue":"2","key":"e_1_2_11_11_1","first-page":"147","article-title":"Anxiety and Depression Associated With Pain and Discomfort of Temporomandibular Disorders","volume":"3","author":"Soares L. F. F.","year":"2020","journal-title":"Brazilian Journal of Pain"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2011.08.007"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3892\/br.2024.1747"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2023.1148176"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnae009"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-2019-0407"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12663"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13985"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-015-1163-5"},{"issue":"2","key":"e_1_2_11_20_1","first-page":"153","article-title":"Role of Psychosocial Factors in the Etiology of Bruxism","volume":"23","author":"Manfredini D.","year":"2009","journal-title":"Journal of Orofacial Pain"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15324796ABM2403_09"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13695"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03650-5"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.11607\/jop.1151"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2023.03.009"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-019-03098-2"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(92)90154-4"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-015-0244-2"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0034-89102007000400015"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.7.4.524"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01492.x"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.1666"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-02737-1"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12661"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2433"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.09.019"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-000-0006-6"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.10.022"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0000000000000335"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221130305"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.09.004"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2009.106"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.01.012"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnw070"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2005.06.074"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003257"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.14476\/jomp.2015.40.2.47"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13331"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.17219\/dmp\/191517"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.06.006"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70158","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joor.70158","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:13:41Z","timestamp":1775535221000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.70158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/joor.70158"],"URL":"https:\/\/doi.org\/10.1111\/joor.70158","archive":["Portico"],"relation":{},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}