Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Philip Westgate, PhD

Committee Member

Richard Kryscio, PhD

Committee Member

Dominique Zephyr, MA

Committee Member

Steven Browning, PhD


Objectives: To test if the structure of a proposed theoretical model comprised of specific observed variables clustered to measure three latent variables of anxiety, depression, and fatigue exhibited good global fit with the observed data and had adequate reliability using confirmatory factor analysis (CFA). A secondary objective was to use structural equation modeling (SEM) to test the direct effect of the latent variables of depression, anxiety, and fatigue on orofacial pain outcomes.

Methods: Subjects were evaluated and treated at an orofacial pain clinic between 2009 and 2014. Those who completed a battery of psychosocial and pain-related questionnaires were invited to participate in an online survey assessing pain outcomes 3-8 years later.

Results: Of 1499 eligible participants that were invited to complete the online survey, 280 provided complete data. Of those, 27% were no longer having an orofacial pain complaint. The initially proposed model structure was modified due to misspecifications. The modified model exhibited adequate global fit indexes (χ2= 111.54 (47), .001, RMSEA = .07 (.053, .087), CFI =.971, SRMR=.495) and acceptable measures of reliability. None of the proposed predictors of the modified model had a direct effect on pain outcomes (p > .05) in the SEM analysis.

Discussion: The findings suggest that neither fatigue nor psychological factors were significant predictors of orofacial pain outcomes. Approximately 75% of the participants continued to have an orofacial pain complaint. Future research should explore if these associations are sample-, diagnosis-, or gender-specific.

Included in

Public Health Commons