Factors associated with psychological adjustment in adults with cleft lip and/or palate: Findings from a national survey in the United Kingdom

Costa, Bruna; Ardouin, Kenny; Stock, Nicola Marie

Abstract

Objectives: Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. Design: A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with (University). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter’s Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. Results: Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. Conclusions: Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.

• Journal Article Type: Article
• Acceptance Date: Jun 8, 2021
• Online Publication Date: Jul 8, 2021
• Publication Date: Apr 1, 2022
• Deposit Date: Jun 17, 2021
• Publicly Available Date: Jul 14, 2021
• Journal: Cleft Palate-Craniofacial Journal
• Print ISSN: 1055-6656
• Electronic ISSN: 1545-1569
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 59
• Issue: 4_suppl2
• Pages: S7-S17
• DOI: https://doi.org/10.1177/10556656211028494
• Public URL: https://uwe-repository.worktribe.com/output/7474302