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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


Kenny Ardouin

Nicola Stock
Occasional Associate Lecturer - HAS - HSS


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.


Costa, B., Ardouin, K., & Stock, N. M. (2022). Factors associated with psychological adjustment in adults with cleft lip and/or palate: Findings from a national survey in the United Kingdom. Cleft Palate-Craniofacial Journal, 59(4_suppl2), S7-S17.

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
Public URL


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