ABSTRACT
The widely accepted use of a bio-psycho-social model to conceptualize the etiology, maintenance and management of disease conditions, including musculoskeletal pain conditions, has demonstrable clinical implications. For chronic musculoskeletal conditions such as temporomandibular disorders [TMD], factors influencing the oft-found disparities between symptom report, clinical observation and responses to treatment are more likely to involve behavioral, cognitive and emotional processes than pathophysiologic processes. Analyses of longitudinal data from population based studies and clinical trials involving biobehavioral interventions for TMD with follow-up periods from one to five years, provide empirical support that concurrent consideration of physiologic and psychologic findings is indicated in clinical management decisions of both primary and tertiary health care providers. A model currently being developed is presented to explain the relationship between saliency of perceived physical versus psychological symptoms and choices made with regard to deciding to seek biomedical or psychiatric types of health care [Article copies available from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com]
