Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study.

OBJECTIVES: The aim of this longitudinal intervention study was to assess the impact of psychosocial stress and coping response strategies on the clinical outcomes in periodontitis patients treated with non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS: After the administration of psychological questionnaires, patients diagnosed with generalized stage III-IV periodontitis were categorized into different groups depending on their stress levels (10-item perceived stress level (PSS-10)) and coping response strategies (coping responses inventory (CRI)). Clinical data were collected 1 week before and 3 months after the completion of NSPT. RESULTS: Of the 90 patients included at baseline, 27 presented major and 63 minor stress levels, while 40 had avoidance and 50 approach coping behavior. All clinical parameters were similar at the baseline across different categories. At re-evaluation, full-mouth bleeding score (FMBS), mean probing pocket depth (PPD), and number of residual pathological pockets were significantly superior in groups with higher stress levels (p <0.001, p =0.001, and p =0.020, respectively), while higher full-mouth plaque scores (FMPS) and FMBS were found in patients with avoidance coping strategies (p =0.009 and p <0.001, respectively). When jointly evaluated, an added detrimental effect of coping styles on allostatic load was observed. Multivariate analysis confirmed a significant effect of stress levels and coping strategies on final FMBS, but not of coping on mean PPD. CONCLUSION: Psychosocial stress and avoidance coping strategy seem to negatively influence the clinical outcomes of NSPT at short term (NCT04739475; 9/1/2017). PRACTICAL IMPLICATIONS: Based on these findings, patients reflecting these psychological profiles should be considered at greater risk for poor NSPT response and may benefit from complementary stress management strategies.

Trust and distrust in contradictory information transmission.

We analyse the problem of contradictory information distribution in networks of agents with positive and negative trust. The networks of interest are built by ranked agents with different epistemic attitudes. In this context, positive trust is a property of the communication between agents required when message passing is executed bottom-up in the hierarchy, or as a result of a sceptic agent checking information. These two situations are associated with a confirmation procedure that has an epistemic cost. Negative trust results from refusing verification, either of contradictory information or because of a lazy attitude. We offer first a natural deduction system called SecureNDsim to model these interactions and consider some meta-theoretical properties of its derivations. We then implement it in a NetLogo simulation to test experimentally its formal properties. Our analysis concerns in particular: conditions for consensus-reaching transmissions; epistemic costs induced by confirmation and rejection operations; the influence of ranking of the initially labelled nodes on consensus and costs; complexity results.