Structural Modeling of Dental Phobia Severity Based on Anxiety Sensitivity and Negative Dental Experiences: The Mediating Role of Experiential Avoidance in Adults
Keywords:
dental phobia, anxiety sensitivity, negative dental experiences, experiential avoidance, structural equation modelingAbstract
Purpose: This study examined a structural model of dental phobia severity based on anxiety sensitivity and negative dental experiences, with experiential avoidance as a mediator, among adults.
Methods and Materials: A cross-sectional correlational design was used. The sample comprised 400 adults aged 18–60 years recruited from public and private dental clinics. Participants completed the Modified Dental Anxiety Scale, Anxiety Sensitivity Index-3, dental-event section of the Level of Exposure–Dental Experiences Questionnaire, and Acceptance and Action Questionnaire-II. Data were analyzed using confirmatory factor analysis, structural equation modeling, and bias-corrected bootstrapping with 5,000 resamples.
Findings: The partial mediation model demonstrated acceptable fit, χ²/df = 2.07, CFI = .948, TLI = .941, RMSEA = .052, and SRMR = .047. Anxiety sensitivity (β = .31), negative dental experiences (β = .29), and experiential avoidance (β = .39) directly predicted dental phobia severity (all p < .001). Anxiety sensitivity (β = .42) and negative dental experiences (β = .24) also predicted experiential avoidance (both p < .001). Experiential avoidance significantly mediated the effects of anxiety sensitivity (β = .164, 95% CI [.112, .225]) and negative dental experiences (β = .094, 95% CI [.058, .142]) on dental phobia severity. The model explained 61% of outcome variance.
Conclusion: Experiential avoidance partially explains how cognitive vulnerability and adverse dental experiences contribute to dental phobia. Assessment and treatment should target catastrophic interpretations, distressing dental memories, and avoidance processes.
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Copyright (c) 2025 Mohammad Shayan Kolahdouzan (Author); Ali Nasr Esfahani
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