OVERT VERSUS COVERT MODELING FOR DENTAL FEAR REDUCTION IN CHILDREN

Abstract

The present study compares the relative success of imagination modeling and film modeling for reducing children's dental-related fears. It was expected they would be equally effective for reducing autonomic arousal and behavioral disruptiveness.;Sixty children, eleven to seventeen, were matched for sex, general health, and dental treatment. Subjects were randomly assigned to three groups, each consisting of 20 subjects, half female. Overt modeling subjects viewed a videotape of a model coping with restorations to be performed. Covert modeling subjects viewed a videotape including imagery practice, which guided them through restorations. Control subjects saw a filmed reading of a descriptive passage. Anxiety was assessed in one session according to self-report, behavioral disruptiveness, and perspiration level.;Fearful patients were screened by the Dental Anxiety Scale (DAS), a self-report measure which was discarded from further consideration because it showed no significant results or trends. Disruptiveness during treatment was assessed using the Behavior Profile Rating Scale (BPRS), based on corroborated ratings of the hygienist and dentist. It showed a significant reduction of disruptiveness in covert condition and revealed overt and covert modeling conditions were equally effective in reducing anxiety. The Palmar Swear Index (PSI), administered pre- and post-experimental treatments and at the completion of restorations, showed females in general had a higher index than males. Males and females responded differentially. Overt modeling males showed the greatest reduction in PSI scores. For females, overt modeling yielded higher PSI scores than did covert modeling, but not significantly so. Covert modeling subjects' anxiety decreased most between the first and second PSI, while overt subject's anxiety decreased most between the second and third PSI. In general, covert and overt modeling were equally effective at reducing PSI scores. To maximize decrease in anxiety over time a combination of the two strategies is suggested.