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Toward a conceptual and methodological shift in craniofacial research

Stock, Nicola Marie; Feragen, Kristin Billaud; Moss, Tim P.; Rumsey, Nichola


Kristin Billaud Feragen


© The Author(s) 2017. Objective: To date, research investigating the psychological impact of craniofacial conditions has produced variability across outcomes. The aims of this article were to summarize the challenges that may contribute to this variability, and to offer alternative perspectives and approaches to guide future research and practice. Design: A comprehensive evaluation of papers exploring adjustment to congenital craniofacial conditions was conducted. Methodological approaches and underlying conceptual issues were identified and summarized. Results: The conceptual limitations identified include inherent challenges pertaining to the multifactorial and fluctuating nature of adjustment, a lack of consensus regarding the primary constituents of a positive outcome, scant use of appropriate models and theories, and a predominant focus on “deficits” over “strengths.” The methodological shortcomings identified include a lack of representative samples, biomedical inclusion/exclusion criteria, inconsistency in measurement, a relative absence of the patient perspective, variability in approaches to data analysis and interpretation, and the failure to draw on knowledge from other disciplines and related fields of health research. Findings are believed to be relevant to all disciplines involved in craniofacial research and practice. Conclusions: Existing literature remains markedly affected by a range of conceptual and methodological challenges, despite these challenges being identified 25 years ago. The present article proposes that a shift in the way we conceptualize and study craniofacial conditions is needed, in order to construct a comprehensive understanding of adjustment to craniofacial conditions, and to address the key unanswered questions important to all stakeholders.


Stock, N. M., Feragen, K. B., Moss, T. P., & Rumsey, N. (2018). Toward a conceptual and methodological shift in craniofacial research. Cleft Palate-Craniofacial Journal, 55(1), 105-111.

Journal Article Type Article
Acceptance Date May 20, 2016
Online Publication Date Dec 14, 2017
Publication Date Jan 1, 2018
Deposit Date Jun 6, 2016
Journal Cleft Palate-Craniofacial Journal
Print ISSN 1055-6656
Electronic ISSN 1545-1569
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 55
Issue 1
Pages 105-111
Keywords cleft, craniofacial, research, measurement, outcome, method, visible difference
Public URL
Publisher URL
Additional Information Additional Information : © 2018. Reprinted by permission of SAGE Publications


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