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Gu B, Johns AL, Binhuwaishel L, Dass A, Sheller B, Kapadia HP, Yen SLK. Impact of protraction or orthognathic surgery for class III malocclusion on longitudinal quality of life in patients with cleft lip and palate. Orthod Craniofac Res 2024. [PMID: 38817081 DOI: 10.1111/ocr.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES This study assessed overall quality of life (QoL) over time in youth with cleft lip and palate (CLP) undergoing maxillary protraction treatment or orthognathic surgery for class III malocclusion to identify any differences in QoL based on treatment group and outcome success. MATERIALS AND METHODS A prospective longitudinal cohort study was conducted in two pediatric hospitals. The Short Form Health Survey (SF-12) measured physical and mental QoL prior to treatment, at maximal correction, at treatment completion, and at 1-year post treatment. Analyses included one-sample, two-sample, and paired t-tests and analyses of variance and covariance. RESULTS Participants (N = 91) either completed protraction (n = 53) at age 11-14 or surgery (n = 38) at age 16-21. Participants were mostly Latinx (67%) males (55%) born with unilateral CLP (81%) and there were no demographic differences between the two groups other than age. The total sample's QoL was in the average range and significantly higher than national norms. No significant differences were found in QoL-based outcome success; however, the protraction group showed a gradual physical QoL improvement over time, while the surgery group experienced a temporary drop in physical QoL postoperatively. At treatment completion, higher physical QoL was associated with higher socioeconomic status. At a year post treatment, mental QoL was significantly higher for males. CONCLUSION Both protraction and surgery appear to be acceptable treatment options in terms of overall QoL for youth with CLP. While treatment success did not impact QoL, there were some differences in physical QoL coinciding with the treatment phase as well as individual factors.
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Affiliation(s)
- Bocheng Gu
- Department of Pharmaceutical and Health Economics, School of Pharmacy, University of Southern California, Los Angeles, California, USA
| | - Alexis L Johns
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lamia Binhuwaishel
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Amarjit Dass
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Barbara Sheller
- Department of Dentistry, Seattle Children's Hospital and School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Hitesh P Kapadia
- Department of Dentistry, Seattle Children's Hospital and School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Stephen L-K Yen
- Division of Dentistry, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Stock NM, Costa B, White P, Eve L, Bates AJ. Assessing Appearance, Speech, and Hearing (dis)Satisfaction in Individuals with Cleft Lip and/or Palate: A Contribution to General Population Norms. Cleft Palate Craniofac J 2024:10556656241241127. [PMID: 38509820 DOI: 10.1177/10556656241241127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Individuals with cleft lip and/or palate (CL/P) may grow up with a visible facial difference, alongside speech and/or hearing challenges. Self-perceptions are stronger predictors of psychosocial adjustment than objective assessments, highlighting the importance of patient-reported outcome measures. Previously titled the Satisfaction with Appearance (SwA) questionnaire, the Cleft Hearing, Appearance and Speech Questionnaire (CHASQ) has been used in several countries to assess patient satisfaction, guide clinical decision-making, and conduct craniofacial research, but has lacked general population norms from which to draw comparisons. The aim of this study was to contribute to the development of norms by utilising existing data collected in the United Kingdom (UK) in 2004 using the original SwA. METHODS SwA data collected from school pupils (n = 761) aged 10-16 years were analysed across age and gender. RESULTS Hair, Eyes and Ears received the highest ratings, while Teeth received the lowest ratings. Those who were younger, and those who were male, generally rated their appearance more favourably. Thresholds are proposed to identify young people in need of clinical monitoring (10%) and intervention (5%). DISCUSSION This study supports the potential of the CHASQ as a clinically useful outcome measure and research tool with the ability to identify appearance concerns in relation to specific facial features, as well as overall appearance satisfaction in young people with and without CL/P. Further validation of its use in the CL/P population and other patient groups, as well as countries outside the UK would add additional weight to the CHASQ's utility.
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Affiliation(s)
- Nicola M Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Bruna Costa
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Paul White
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Lauren Eve
- Mathematics and Statistics Research Group, University of the West of England, Bristol, UK
| | - Amanda J Bates
- Centre for Health Services Studies, University of Kent, Canterbury, UK
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Guest E, Williamson H, Harcourt D. Congenital melanocytic naevus (CMN) through the lens: Using photo-elicitation interviews to explore adjustment in adolescents with a rare birthmark condition. Body Image 2024; 48:101656. [PMID: 38091858 DOI: 10.1016/j.bodyim.2023.101656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 03/05/2024]
Abstract
Adolescents with the rare birthmarks congenital melanocytic naevi (CMN) experience physical and psychosocial challenges, many of which stem from looking different from the 'norm'. However, some adjust and have positive experiences. Understanding the lived experiences of adolescents who have adjusted to CMN can provide a holistic picture of adjustment and inform the development of support and interventions for others with the condition. Open, participant-driven photo-elicitation interviews were conducted with four White females (15-17 years) who self-identified as having adjusted to CMN. Participants chose five photographs which were used to guide the interviews (47-80 min). Interpretative phenomenological analysis (IPA) was used to analyse the transcribed interview data. Three superordinate themes were identified: 'Accepting My 'True' Self' (1), 'I am Not Alone in This' (2), and 'Developing as a Person' (3). The themes related to accepting CMN as part of their identity, developing a positive body image (e.g., body appreciation, broad conceptualisations of beauty, body image flexibility), feeling supported and accepted by family, friends, and others with CMN, and developing adaptive coping skills. Findings suggest positive body image may be important for adjustment and can be determined by an individual. The benefits of using photo-elicitation within appearance research are discussed.
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Affiliation(s)
- Ella Guest
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, United Kingdom.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, United Kingdom
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4
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Gavelle P, Dissaux C, Dupont M, Khonsari RH, Picard A. Parental and Child Diagnosis Storytelling and Self-Image in French Children With Cleft lip With or Without Cleft Palate. Cleft Palate Craniofac J 2024; 61:200-208. [PMID: 36112838 DOI: 10.1177/10556656221126268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVE Psychosocial adjustment can be challenging for children with cleft lip with or without a cleft palate (CL ± P). Previous studies have linked social integration with self-acceptance and highlighted the impact of the parents' stress on self-acceptance. Teasing can be linked to children having difficulties explaining their diagnosis to others. This prospective research aimed to gain a better understanding of family communication about cleft, children's oral storytelling about their cleft, and explore their self-image and perceived familial acceptance. PARTICIPANTS Parents and their children with CL ± P (N = 54; average age: 5.6 years). DESIGN Semistructured interviews with parents and structured interviews with children were conducted regarding their oral storytelling focusing on scars from cleft lip surgery. Children completed a projective test to explore their self-image and perceptions of familial acceptance. Language screening was completed with the French Wechsler Preschool Primary Scale of Intelligence-Fourth Edition. RESULTS Only 30% of children explained their cleft in a way appropriate for peers, including presence at birth, having had surgery, and scar location. Children's ability to explain their cleft was not related to language performance, which was in the average range of 84%. Children's cleft explanations were dependent on parents' narratives and education methods, including the use of verbal explanations and preoperative photographs. Children's storytelling was related to their self-image and perceived parental acceptance. CONCLUSION Cleft teams should assist families in building their cleft story based on a complete explanation with photographs and a positive and accepting approach.
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Affiliation(s)
- Pascale Gavelle
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre de Référence Fente et Malformations Faciales MAFACE, Filière Maladies Rares Tête Cou, Université de Paris, Paris, France
| | - Caroline Dissaux
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique des Hôpitaux Universitaires de Strasbourg, Centre de Compétence des Fentes labio-palatines, Strasbourg, France
| | - Mathilde Dupont
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre de Référence Fente et Malformations Faciales MAFACE, Filière Maladies Rares Tête Cou, Université de Paris, Paris, France
| | - Roman Hossein Khonsari
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre de Référence Fente et Malformations Faciales MAFACE, Filière Maladies Rares Tête Cou, Université de Paris, Paris, France
| | - Arnaud Picard
- Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre de Référence Fente et Malformations Faciales MAFACE, Filière Maladies Rares Tête Cou, Université de Paris, Paris, France
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5
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Waite E, Jenkinson E, Kershaw S, Guest E. Psychosocial Interventions for Children and Young People With Visible Differences Resulting From Appearance-Altering Conditions, Injury, or Treatment Effects: An Updated Systematic Review. J Pediatr Psychol 2024; 49:77-88. [PMID: 37944011 PMCID: PMC10799722 DOI: 10.1093/jpepsy/jsad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Children and young people with visible differences can experience psychosocial difficulties, such as anxiety and teasing by others. Interventions targeting difficulties have previously been reviewed by Jenkinson et al. This review aimed to identify and critically assess recent studies evaluating the effectiveness of psychosocial interventions for children and young people with visible differences on psychosocial wellbeing, self-esteem, and social experiences and compare the findings with Jenkinson et al. using a replacement review process. METHODS Inclusion criteria are as follows: studies with participants aged 0-18 years with visible differences; investigating a psychosocial intervention; including comparison with an alternative intervention, control group, or pre- and post-intervention; and including a quantitative measure assessed pre- and post-intervention. Exclusion criteria are as follows: participants with body dysmorphic disorder or appearance changes due to eating disorders or obesity and studies not written in English. MEDLINE, AMED, and PsycInfo were searched and grey literature was included. Results were reviewed against eligibility criteria, data were extracted, and studies were evaluated using the Cochrane Risk of Bias 2 tool. RESULTS Using Jenkinson et al. as one source of studies, 24 studies were included evaluating a range of interventions such as social interaction skills training, residential social camps, and cognitive behavioral therapy. Risk of bias was high in 20 studies and of some concern in four studies. CONCLUSION There is some evidence of the effectiveness of hypnotherapy, a relaxation response resiliency program, integrative body-mind-spirit group, and therapeutic patient education, but more rigorous research is needed to confirm their impact on psychosocial outcomes.
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Affiliation(s)
- Emma Waite
- Centre for Appearance Research, University of the West of England (UWE) Bristol, UK
| | - Elizabeth Jenkinson
- Centre for Appearance Research, University of the West of England (UWE) Bristol, UK
| | | | - Ella Guest
- Centre for Appearance Research, University of the West of England (UWE) Bristol, UK
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Yu M, Sun X, Xu Y, Liu Z, Wu Y, Yang S, Luo F. Mirror, mirror, on the social media … WeChat Moments usage and negative body image among female college students: Evidence from ecological momentary assessment data. Appl Psychol Health Well Being 2023; 15:1046-1064. [PMID: 36516998 DOI: 10.1111/aphw.12425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Negative body image is prevalent among women and may lead to physical and mental health problems. Social media-including China's most popular platform, WeChat Moments-aggregates multiple aspects of appearance-related pressure and therefore is an important risk factor for negative body image. The current study examines the relationship between WeChat Moments usage and body image among female college students and the mediating mechanism of body surveillance. A sample of 151 female college students completed a 7-day ecological momentary assessment (EMA), responded to three surveys per day, and provided a total of 2949 EMA responses. We used multilevel structural equation modeling (MSEM) to examine the hypothesized models at both the between- and within-individual levels. The results showed that both overall WeChat Moments usage and appearance-related exposure on WeChat Moments were inversely and indirectly related to body image through the mediating role of body surveillance at the between-individual level. However, both overall WeChat Moments usage and appearance-related exposure on WeChat Moments were positively and indirectly related to body image through body surveillance at the within-individual level. Our findings indicate that WeChat Moments usage is associated with college women's body image differently at the between- and within-individual level, and body surveillance serves as a crucial underlying mechanism.
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Affiliation(s)
- Mengke Yu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaomin Sun
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yan Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Zhenzhen Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yi Wu
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Shuting Yang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Fang Luo
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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7
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Netherton J, Horton J, Stock NM, Shaw R, Noons P, Evans MJ. Psychological Adjustment in Apert Syndrome: Parent and Young Person Perspectives. Cleft Palate Craniofac J 2023; 60:461-473. [PMID: 34967688 DOI: 10.1177/10556656211069817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To date, limited research has been carried out into the psychological impact of having a diagnosis of Apert syndrome (AS) and the life experiences of families living with this condition. The aim of the current study was to explore psychological adjustment to AS from the perspectives of young people, and their parents, with the broader goal of informing care, and support for this population. Four young people (2 male) aged 11 to 15 years and their mothers were interviewed in their homes using a semistructured interview guide and photo-elicitation methods. Transcripts were analyzed using Interpretive Phenomenological Analysis. Three superordinate themes were identified from the data: (1) Acceptance and Adjustment: A Cyclical Journey; (2) A Barrier to Adjustment: Navigating Treatment; and (3) Facilitating Adjustment: Social Support. Families described adjustment as a cyclical process, which was sensitive to change, particularly in the context of ongoing medical treatment. Families also utilized many resources, particularly in the form of social support, to adjust to the challenges of AS and build resilience. The findings of this study have important implications for the implementation of patient-centered care within designated craniofacial treatment centers, which should at a minimum include the provision of reliable information throughout the treatment pathway, additional support from health professionals at key times of transition, and the coordination of support across medical teams, and other key organizations in the child's life.
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Affiliation(s)
- Jennifer Netherton
- Health in Mind Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Jo Horton
- Health in Mind Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Nicola M Stock
- Centre for Appearance Research, University of the West of England UK, Bristol, United Kingdom
| | - Rachel Shaw
- School of Psychology, 14288Aston University UK, Birmingham, United Kingdom
| | - Peter Noons
- Craniofacial Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Martin J Evans
- Craniofacial Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
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Mavragani A, Feragen KJB, Pripp AH, Nordgreen T, Williamson H, Kling J. Predictors of Adolescents' Response to a Web-Based Intervention to Improve Psychosocial Adjustment to Having an Appearance-Affecting Condition (Young Person's Face IT): Prospective Study. JMIR Form Res 2023; 7:e35669. [PMID: 36652281 PMCID: PMC9892986 DOI: 10.2196/35669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adolescents with a condition affecting their appearance that results in a visible difference can be at risk of psychosocial distress and impaired adjustment. Evidence for the effectiveness of existing interventions in improving psychosocial outcomes is limited, and relevant treatment can be difficult to access. Young Person's Face IT (YPF), a self-guided web-based intervention, has demonstrated potential in reducing social anxiety in adolescents with a visible difference. However, more knowledge is needed about the variables that contribute to variations in intervention effects to identify those who may benefit most from YPF. OBJECTIVE This study aimed to investigate demographic, psychosocial, and intervention-related variables as predictors of overall intervention effects after adolescents' use of YPF. METHODS We used longitudinal data collected as part of a larger, ongoing mixed methods project and randomized controlled trial (ClinicalTrials.gov NCT03165331) investigating the effectiveness of the Norwegian version of YPF. Participants were 71 adolescents (mean age 13.98, SD 1.74 years; range 11-18 years; 43/71, 61% girls) with a wide range of visible differences. The adolescents completed primary (body esteem and social anxiety symptoms) and secondary (perceived stigmatization, life disengagement, and self-rated health satisfaction) outcome measures at baseline and postintervention measurement. The predictor variables were demographic (age and gender), psychosocial (frequency of teasing experiences related to aspects of the body and appearance as well as depressive and anxiety symptoms), and intervention-related (time spent on YPF) variables. RESULTS Two-thirds (47/71, 66%) of the adolescents completed all YPF sessions and spent an average of 265 (SD 125) minutes on the intervention. Backward multiple regression analyses with a 2-tailed P-value threshold of .20 revealed that several variables were retained in the final models and predicted postintervention outcome changes. Body esteem was predicted by age (P=.14) and frequency of teasing experiences (P=.09). Social anxiety symptoms were predicted by gender (P=.12), frequency of teasing experiences (P=.03), depressive and anxiety symptoms (P=.08), and time spent on YPF (P=.06). Perceived stigmatization was predicted by age (P=.09), gender (P=.09), frequency of teasing experiences (P=.19), and depressive and anxiety symptoms (P=.06). Life disengagement was predicted by gender (P=.03), depressive and anxiety symptoms (P=.001), and time spent on YPF (P=.14). Self-rated health satisfaction was predicted by age (P=.008). However, the results were limited by relatively low explained postintervention variance, ranging from 1.6% to 24.1%. CONCLUSIONS This study suggests that adolescent boys, adolescents who experience higher levels of psychosocial distress related to their visible difference, and adolescents who spend sufficient time on YPF may obtain better overall intervention effects.
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Affiliation(s)
| | | | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Oslo, Norway
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Wang Q, Tu R, Jiang Y, Hu W, Luo X. Teasing and Internet Harassment among Adolescents: The Mediating Role of Envy and the Moderating Role of the Zhong-Yong Thinking Style. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095501. [PMID: 35564895 PMCID: PMC9100652 DOI: 10.3390/ijerph19095501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/24/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022]
Abstract
Extant research studies have documented that teen victims of traditional bullying are more likely to be perpetrators of Internet harassment. Teasing is a typical form of verbal bullying, but, unfortunately, its link with Internet harassment perpetration has rarely been investigated to date. Therefore, this study constructed two moderated mediation models to explore the relation between weight-related/competency-related teasing (the two main types of teasing) and Internet harassment, and whether these associations are mediated by envy and moderated by the Zhong-Yong thinking style. A total of 1811 Chinese adolescents (Mage = 13.22 years, SD = 0.97) were investigated to examine the two models. The results clarified that: (1) weight-related/competency-related teasing was positively predictive of adolescent Internet harassment; (2) envy acted a partially mediating role in the associations between weight-related/competency-related teasing and Internet harassment; (3) the Zhong-Yong thinking style not only moderated the link between weight-related/competency-related teasing and envy, with the effect being more profound for a high-level Zhong-Yong thinking style possessed by adolescents, but also moderated the direct link between competency-related teasing and Internet harassment, with the relation being more potent when the level of Zhong-Yong thinking style was low. Nevertheless, the direct link between weight-related teasing and Internet harassment was not moderated by the Zhong-Yong thinking style. These findings are important to comprehend the psychological mechanisms linking weight-related/competency-related teasing to Internet harassment, and provide some enlightenment for preventing and intervening in adolescent Internet harassment perpetration.
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Affiliation(s)
- Qiong Wang
- School of Education, Zhengzhou University, Zhengzhou 450001, China; (Q.W.); (R.T.); (X.L.)
| | - Ruilin Tu
- School of Education, Zhengzhou University, Zhengzhou 450001, China; (Q.W.); (R.T.); (X.L.)
| | - Yihe Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;
| | - Wei Hu
- Information Engineering University, Zhengzhou 450001, China
- Correspondence:
| | - Xiao Luo
- School of Education, Zhengzhou University, Zhengzhou 450001, China; (Q.W.); (R.T.); (X.L.)
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10
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Reducing social anxiety in adolescents distressed by a visible difference: Results from a randomised control trial of a web-based intervention. Body Image 2022; 40:295-309. [PMID: 35121566 DOI: 10.1016/j.bodyim.2022.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 01/28/2023]
Abstract
A visible difference to the face or body may challenge adolescents' adjustment and engagement in life activities, where some require psychosocial support. However, evidence is limited for whether existing interventions for this adolescent group reduce social or appearance-related distress. We therefore conducted a parallel-group, randomised control trial to evaluate the effectiveness of Young Person's Face IT, a self-guided web-based psychosocial intervention developed for adolescents with a visible difference who experience distress. Adolescents (N = 189, aged 11-18) from two countries (Norway and the Netherlands), were randomly allocated to an intervention group or care as usual (CAU). Outcomes were body esteem, social anxiety, perceived stigmatisation, and life disengagement. Compared with CAU, participants who completed Young Person's Face IT showed reductions in social anxiety symptoms (ηp2 = 0.06). No significant improvements were found for the other outcomes. This study endorses web-based psychosocial support in reducing social anxiety in adolescents distressed by a visible difference. Future studies are needed to confirm the effectiveness of Young Person's Face IT and to explore potential long-term effects.
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11
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Parental Reports of Intervention Services and Prevalence of Teasing in a Multinational Craniofacial Microsomia Pediatric Study. J Craniofac Surg 2021; 32:2687-2691. [PMID: 34727472 DOI: 10.1097/scs.0000000000007999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ABSTRACT Children with craniofacial microsomia (CFM) are at increased risk for educational and social concerns. This study describes intervention services and frequency of teasing in a multinational population of children with CFM. Caregivers of children with CFM ages 3 to 18 years in the US and South America were administered a questionnaire. Additional information was gathered from medical charts and photographs. Participants (N = 169) had an average age of 10.1 ± 6.2 years, were primarily male (60%), and from the US (46%) or Colombia (32%). Most participants had microtia and mandibular hypoplasia (70%). They often had unilateral (71%) or bilateral (19%) hearing loss and 53% used a hearing aid. In the US, special education services were provided for 48% of participants enrolled in school; however, similar services were rare (4%) in South America and reflect differences in education systems. Access to any intervention service was higher in the US (80%) than in South America (48%). Caregivers reported children showed diagnosis awareness by an average age of 4.4 ± 1.9 years. Current or past teasing was reported in 41% of the children, starting at a mean age of 6.0 ± 2.4 years, and most often took place at school (86%). As half of the US participants received developmental and academic interventions, providers should screen for needs and facilitate access to services. Given diagnosis awareness at age 4 and teasing at age 6, providers are encouraged to assess for psychosocial concerns and link to resources early in treatment.
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12
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Zelihić D, Williamson H, Kling J, Feragen KB. "It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference. Body Image 2021; 38:306-316. [PMID: 34052591 DOI: 10.1016/j.bodyim.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.
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Affiliation(s)
- Deniz Zelihić
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
| | - Kristin B Feragen
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
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13
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Costa B, Ardouin K, Stock NM. Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom. Cleft Palate Craniofac J 2021; 59:S7-S17. [PMID: 34235990 DOI: 10.1177/10556656211028494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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 the Centre for Appearance Research CAR at the University of the West of England (UWE). 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.
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Affiliation(s)
- Bruna Costa
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Kenny Ardouin
- Cleft Lip and Palate Association, London, United Kingdom
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14
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Alighieri C, D'haeseleer E, Bettens K, Bonte K, Vermeersch H, Vermeire N, Claeys M, Sseremba D, Galiwango G, Van Lierde K. Sociodemographics and Quality of Life in Dutch-Speaking Adolescents and Adults With and Without a Cleft Lip and/or Palate. Cleft Palate Craniofac J 2021; 59:S65-S73. [PMID: 34142586 DOI: 10.1177/10556656211024513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the impact of living with a cleft lip and/or cleft palate (CL/P) on sociodemographic variables, quality of life, aesthetics, life satisfaction, and social distress in Dutch-speaking adolescents and adults. DESIGN Cross-sectional study. PARTICIPANTS Thirty Dutch-speaking participants with a CL/P with a mean age of 26.93 years (SD = 11.69) and an age- and gender-matched control group of 30 participants (19 men and 11 women) without a CL/P with a mean age of 26.87 years (SD = 11.73). MAIN OUTCOME MEASURES Self-reported outcomes of sociodemographics, quality of life, aesthetics, life satisfaction, social distress, and impact of cleft on well-being and functioning. RESULTS No significant differences in educational level, employment, monthly net income, marital status, and having children were found between participants with and without a CL/P. In addition, quality of life, overall aesthetics, life satisfaction, and social distress did not differ between the 2 groups. Among participants with CL/P, there were no gender differences in the influence of their CL/P on daily functioning, well-being, social contacts, family life, applying for a job, work, education, or leisure time. CONCLUSION The findings revealed no differences between participants with and without a CL/P with regard to sociodemographics, quality of life, aesthetics, life satisfaction, or social distress. There were no gender differences in the influence of cleft on well-being and functioning. Longitudinal research can help determine possible fluctuations in the impact of living with a CL/P across the life span.
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Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Katrien Bonte
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Nele Vermeire
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Merel Claeys
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Daniel Sseremba
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - George Galiwango
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
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15
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Bous RM, Lyamichev A, Kmentt A, Valiathan M. Bias in a blink: Shedding light on implicit attitudes toward patients with a cleft lip. Am J Orthod Dentofacial Orthop 2021; 160:200-208. [PMID: 33958261 DOI: 10.1016/j.ajodo.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Previous studies have shown that patients with cleft lip and/or palate may be stigmatized in society. The objective of this study was to use an implicit association test to evaluate the subconscious biases of non-health care providers and orthodontists against patients with a repaired cleft lip (CL). METHODS Respondents participated in an implicit association test. Pictures of patients with CL and controls were shown to participants, along with terms representing positive and negative attributes. Participants were prompted to match pictures to the attributes. The software algorithm detected whether the participants were more likely to associate CL with positive or negative terms than controls. Demographic information was collected to measure the association between some sociodemographic factors and implicit biases. RESULTS Of 130 valid participants, 52 were orthodontists and 78 were non-health care providers. The entire sample displayed a significant implicit bias against CL (P <0.001). Overall, orthodontists tended to exhibit slightly higher levels of implicit biases against CL than non-health care providers, but the difference was not significant when controlling for sociodemographic factors (P = 0.34). Females showed significantly lower implicit biases against CL than males (P = 0.046). Spearman correlations showed that older people and those who reported a more conservative political affiliation tended to show slightly higher levels of implicit biases against CL (P <0.007). CONCLUSIONS Orthodontists and non-health care providers showed moderate but significant levels of implicit biases against patients with clefts. Males, older age groups, and patients with a more conservative political affiliation tended to exhibit slightly higher levels of biases than females, younger people, and those with a more liberal political affiliation.
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Affiliation(s)
- Rany M Bous
- Craniofacial and Special Care Orthodontics, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio.
| | - Anthony Lyamichev
- School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Ashleigh Kmentt
- School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Manish Valiathan
- Mt Sinai-Dr Edward Reiter Fellowship Program, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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16
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Ardouin K, Hotton M, Stock NM. Interpersonal Relationship Experiences in Adults Born With Cleft Lip and/or Palate: A Whole of Life Survey in the United Kingdom. Cleft Palate Craniofac J 2021; 58:1412-1421. [PMID: 33535806 DOI: 10.1177/1055665620987109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Previous research has suggested that adults with a cleft lip and/or palate (CL/P) may find their familial, friend, collegial, and/or romantic relationships impacted by their condition. Building on this prior work, this study examined the self-reported interpersonal experiences of a national sample of adults born with CL/P. DESIGN An online survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research. Data from 181 participants were included in the present study, collected between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests. RESULTS Most participants reported having good relationships with family members and existing friends with similar patterns of marriage as the general population. However, some experienced difficulties initiating new friendships and romantic relationships. Participants described bullying and discrimination in adulthood, most often in public settings and the workplace. Participants reported lower satisfaction with intimate relationships and less secure attachment compared to the general population. Concerns regarding the heritability of CL/P and its impact on the decision to have a family were also reported. CONCLUSIONS Individuals with CL/P are at risk of negative social experiences, which if not appropriately addressed may impact psychological well-being in adulthood. The findings illustrate the importance of routine psychosocial support from childhood onward to help individuals with CL/P build social skills, self-esteem, and social confidence and to develop mutually fulfilling friendships and intimate relationships. Additionally, societal campaigns to raise awareness and target discrimination may be helpful.
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Affiliation(s)
- Kenny Ardouin
- Cleft Lip and Palate Association, The Green House, London, United Kingdom
| | - Matt Hotton
- The Spires Cleft Centre, 11269John Radcliffe Hospital, Oxford, United Kingdom
| | - Nicola Marie Stock
- Centre for Appearance Research, 1981University of the West of England, Bristol, United Kingdom
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17
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Kelly SN, Shearer J. Appearance and Speech Satisfaction and Their Associations With Psychosocial Difficulties Among Young People With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2020; 57:1008-1017. [PMID: 32463719 PMCID: PMC7361652 DOI: 10.1177/1055665620926083] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Previous research has found lower appearance and speech satisfaction among those with cleft lip and/or palate (CL/P) compared to noncleft control groups. Less research has been conducted into which groups report the lowest satisfaction and how these two factors relate to psychosocial difficulties. This study aimed to investigate (1) differences in appearance and speech satisfaction by diagnosis and age among young people with CL/P and (2) associations between appearance and speech satisfaction and emotional and social difficulties. DESIGN Self-report questionnaires that had been collected between June 2016 and August 2018 within routine clinical practice were analyzed. SETTING A tertiary pediatric hospital in London. PATIENTS A total 130 nonsyndromic 10- and 15-year-old patients with CL/P. MAIN OUTCOME MEASURES Cleft Hearing, Appearance and Speech Questionnaire; Strengths and Difficulties Questionnaire. RESULTS The CLP group reported significantly lower appearance satisfaction compared to the CP group (P = .005). The 15-year-olds reported significantly lower appearance satisfaction compared to the 10-year-olds (P = .008). No significant differences were found in speech satisfaction by diagnosis (P = .06) or age (P = .064). Significant negative associations were found at 15 years old between appearance satisfaction and emotional difficulties, speech satisfaction and emotional difficulties, appearance satisfaction and social difficulties, and speech satisfaction and social difficulties (P < .05 all correlations). Only the latter two associations were significant at 10 years old (P < .05). CONCLUSIONS The findings have important implications as appearance and speech dissatisfaction may be ways in which to identify those at risk of psychosocial difficulties within clinical settings.
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Affiliation(s)
- Sarah N. Kelly
- Department of Psychology, University of Bath, United Kingdom
- Department of Paediatric Psychology, Great Ormond Street Hospital, London, United Kingdom
| | - Joanna Shearer
- Department of Paediatric Psychology, Great Ormond Street Hospital, London, United Kingdom
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18
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Management and Reconstruction of a Massive Neonatal Neck Teratoma. J Craniofac Surg 2020; 31:e254-e256. [PMID: 32195831 DOI: 10.1097/scs.0000000000006210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cervical teratoma is a rare tumor comprised of multiple tissue types. These masses can result in significant functional and aesthetic complications, and surgical intervention is the mainstay of treatment. The authors report the treatment and 8-year follow-up of a patient born with a massive cervicofacial teratoma. The mass was diagnosed in utero and required perinatal airway management. The patient underwent several procedures to enhance his appearance and function early on in life with an excellent outcome at intermediate follow-up.
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19
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Crerand CE, Rumsey N, Kazak A, Clarke A, Rausch J, Sarwer DB. Sex differences in perceived stigmatization, body image disturbance, and satisfaction with facial appearance and speech among adolescents with craniofacial conditions. Body Image 2020; 32:190-198. [PMID: 32006855 PMCID: PMC8930279 DOI: 10.1016/j.bodyim.2020.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 01/01/2023]
Abstract
Youth with craniofacial conditions often have appearance and speech differences and are vulnerable to social stigmatization and body image disturbances. Given sociocultural pressures for female attractiveness, adolescent girls with craniofacial conditions may be especially vulnerable to body dissatisfaction and appearance-related social stigmatization, though such sex differences have been infrequently studied in this population. This study aimed to: (1) examine sex differences in body image disturbance, satisfaction with speech and facial appearance, and perceived stigmatization among adolescents with craniofacial conditions; and (2) evaluate whether stigmatization perceptions are predictive of body image disturbance and satisfaction with facial appearance and speech. Using a cross-sectional design, 110 adolescents from two craniofacial centers completed measures of body image disturbance, satisfaction with speech and facial appearance, and perceived stigmatization. Females reported significantly greater levels of body image disturbance and lower satisfaction with facial appearance compared to males. There were no significant sex differences for satisfaction with speech or perceived stigmatization. Perceived stigmatization was a significant predictor of body image disturbance, and satisfaction with facial appearance and speech while controlling for sex, body mass index, and age. Interventions to prevent and/or address body image and stigmatization concerns are clinically indicated for both sexes.
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Affiliation(s)
- Canice E. Crerand
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital (700 Children’s Drive, Columbus, OH 43205) and Department of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine (370 W. 9th Avenue, Columbus, OH 43210)
| | - Nichola Rumsey
- Center for Appearance Research, Department of Psychology, University of the West of England (Coldharbour Lane, Bristol, BS16 1QY, United Kingdom)
| | - Anne Kazak
- Nemours Children’s Health System (1600 Rockland Road, Wilmington, DE 19803) and Sidney Kimmel Medical College of Thomas Jefferson University (1025 Walnut Street #100, Philadelphia, PA, 19107)
| | - Alexandra Clarke
- Center for Appearance Research, Department of Psychology, University of the West of England (Coldharbour Lane, Bristol, BS16 1QY, United Kingdom)
| | - Joseph Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital (700 Children’s Drive, Columbus, OH 43205)
| | - David B. Sarwer
- College of Public Health, Temple University (3223 N. Broad Street, Suite 175, Philadelphia, PA 19140)
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20
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Ardouin K, Hare J, Stock NM. Emotional Well-Being in Adults Born With Cleft Lip and/or Palate: A Whole of Life Survey in the United Kingdom. Cleft Palate Craniofac J 2020; 57:877-885. [PMID: 31906694 DOI: 10.1177/1055665619896681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives: Previous research with adults born with cleft lip and/or palate (CL/P) has identified a range of concerns regarding mental health and quality of life, concluding that overall emotional functioning is poorer compared to the general population. The aim of the current study was to build on this previous work by investigating the self-reported emotional well-being of adults born with CL/P in the United Kingdom. Design: An online, mixed methods survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research at the University of the West of England. A total of 207 eligible responses were received between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests. Results: Almost half of the sample reported a diagnosis of a mental health condition. Scores on standardized measures indicated significantly lower global self-worth, higher levels of fear of negative appearance evaluation, and lower self-perceived job competence compared to normative data. Scores of overall body esteem were in line with the general population. Most participants had not received psychological support from their regional CL/P team and 41% were unaware of their entitlement to treatment from the National Health Service. Conclusions: Individuals with CL/P may be at risk of emotional distress persisting into adulthood. The integration of routine psychological support from an early age is highly recommended, as is information for young adults about to complete routine treatment. Comprehensive psychological screening for adults returning to the service later in life is also strongly advised.
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Affiliation(s)
- Kenny Ardouin
- Cleft Lip and Palate Association, London, United Kingdom
| | - Jess Hare
- National Cleft Surgical Service for Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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21
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Shi P, Huang Y, Kou H, Wang T, Chen H. Risk Factors for Facial Appearance Dissatisfaction Among Orthognathic Patients: Comparing Patients to a Non-Surgical Sample. Front Psychol 2019; 10:2775. [PMID: 31920824 PMCID: PMC6917591 DOI: 10.3389/fpsyg.2019.02775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/25/2019] [Indexed: 11/13/2022] Open
Abstract
This study conducted a cross-sectional investigation of facial appearance dissatisfaction between patients before undergoing orthognathic surgery and a non-surgical sample to evaluate the potential influencing factors of facial appearance dissatisfaction. A sample of 354 participants completed a set of questionnaires concerning facial appearance dissatisfaction, interpersonal pressure, media pressure, and fear of negative appearance evaluation (112 patients, 242 controls). The patients reported higher facial appearance dissatisfaction, more media pressure, more interpersonal pressure, and a greater fear of negative appearance evaluation among others than the control group. Moreover, regression analyses identified interpersonal pressure and fear of negative appearance evaluation as the main predictors of facial appearance dissatisfaction whether in the orthognathic patients or the control groups. The associations between the perceptions of interpersonal pressure, fear of negative appearance evaluation, and facial appearance dissatisfaction support the possible utility of strengthening social experiences and psychological intervention in preventing and treating these appearance-concerns, especially for the orthognathic patients.
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Affiliation(s)
- Pan Shi
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Yufei Huang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Hui Kou
- Faculty of Psychology, Southwest University, Chongqing, China
- School of Management, Zunyi Medical University, Guizhou, China
| | - Tao Wang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- *Correspondence: Tao Wang,
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, China
- Hong Chen,
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22
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Bous RM, Hazen RA, Baus I, Palomo JM, Kumar A, Valiathan M. Psychosocial Adjustments Among Adolescents With Craniofacial Conditions and the Influence of Social Factors: A Multi-Informant Study. Cleft Palate Craniofac J 2019; 57:624-636. [PMID: 31769310 DOI: 10.1177/1055665619888308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Previous studies have investigated psychosocial adjustments among adolescents with cleft lip and/or palate (CL/P), but our understanding of other craniofacial conditions remains limited. The objective of this study is to compare psychosocial adjustments among 3 groups of adolescents: craniofacial conditions other than cleft lip and/or palate (craniofacial anomaly [CFA]), CL/P, and controls (CON). Our secondary objective is to examine how social factors may predict the adjustments levels. DESIGN Cross-sectional, multi-informant, controlled survey study. PARTICIPANTS Aged 11- to 17-year olds. Craniofacial anomaly (n = 49), isolated CL/P (n = 42), and 55 CON. Total = 146. OUTCOME MEASURES The Strengths and Difficulties Questionnaire (self-report, parent report, and teacher report). RESULTS All 3 informant groups displayed similar patterns, where CFA reported the highest difficulties, followed by CL/P, while CON scored the lowest. Parent reports demonstrated significant differences among the 3 groups for most subscales and were emphasized for peer problems. Self-reports showed significant differences between CFA and CON for total scores and peer problems, while teacher reports showed significant differences for peer problems only. Craniofacial anomaly displayed the highest frequency of abnormal psychosocial adjustments, followed by CL/P. Experiencing bullying or teasing predicted increased difficulties, while having a good friend predicted decreased difficulties. CONCLUSIONS Adolescents with CFA, and to a lesser extent CL/P, may be at a higher risk of having psychosocial problems. Peer problems may constitute the biggest challenge that CFA and CL/P confront. Social factors, especially being bullied or having a good friend, may predict the psychosocial well-being of adolescents with craniofacial conditions.
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Affiliation(s)
- Rany M Bous
- Craniofacial, Surgical and Special Care Orthodontics Fellowship Program, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Rebecca A Hazen
- Departments of Pediatrics and Psychology, Case Western Reserve University School of Medicine.,Division of Developmental/Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital, University Hospital's Cleveland Medical Center, Cleveland, OH, USA
| | - Irene Baus
- Cleft and Craniofacial Center, Rainbow Babies and Children's Hospital, University Hospital's Cleveland Medical Center, Cleveland, OH, USA
| | - J Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Anand Kumar
- Department of Pediatric Plastic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Plastic Surgery, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Manish Valiathan
- Craniofacial, Surgical and Special Care Orthodontics Fellowship Program, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
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23
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Schmidt J, Martin A. Appearance Teasing and Mental Health: Gender Differences and Mediation Effects of Appearance-Based Rejection Sensitivity and Dysmorphic Concerns. Front Psychol 2019; 10:579. [PMID: 30949099 PMCID: PMC6435521 DOI: 10.3389/fpsyg.2019.00579] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/01/2019] [Indexed: 01/03/2023] Open
Abstract
Appearance teasing is a common phenomenon in social interactions, especially in adolescence. Several studies have shown its negative impact on mental health as well as on body image. While these findings prove stable in various contexts, less evidence is available for possible gender differences in these relationships. In particular, the role of two important body image variables - appearance-based rejection sensitivity (ARS) and dysmorphic concerns - and their contribution to mental health impairments has not been assessed in gender-specific process models. In a cross-sectional survey-study (N = 501; 407 f, 94 m), we retrospectively assessed early appearance teasing experiences, as well as current ARS, dysmorphic concerns, depression, anxiety, and self-esteem. We analyzed gender differences in these variables and their interrelations. We then examined the mediating role of ARS and dysmorphic concerns in explaining mental health variables in adulthood due to early appearance teasing in gender-specific serial-mediation models. The results show high ratios of early teasing experiences, but no significant gender difference regarding the frequency of early appearance teasing. While teasing experiences were significantly related to body image variables in adulthood in both genders (rs > 0.32; ps < 0.010), we observed significant relations with mental health outcomes in women (rs > 0.30; ps < 0.001) but not in men (rs < 0.20; ps > 0.250). Serial mediation models show that ARS and dysmorphic concerns mediate the effects of appearance teasing on mental health in all outcomes in women (ΔR2 > 0.17), but not in men (ΔR2 < 0.03). Findings remained stable when controlling for Body-Mass-Index, age, and relationship-status. The findings show similar frequencies of appearance teasing and associated negative effects on body image in men and women. Specifically, in women, the effects of teasing on mental health were stronger and mediated by ARS and dysmorphic concerns. Overall, the results point to the relevance of ARS for etiological models of body image disorders and female mental health. However, men did not show the same relationships of teasing and mental health. Differential resilience factors regarding the negative effects of early appearance teasing could be an important target for future research.
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Affiliation(s)
- Jennifer Schmidt
- Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany
- Department of Psychology, HSD Hochschule Döpfer University of Applied Sciences, Cologne, Germany
| | - Alexandra Martin
- Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany
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Dantas AG, Alonso DA, Sánchez-Miguel PA, Del Río Sánchez C. Factors Dancers Associate with their Body Dissatisfaction. Body Image 2018; 25:40-47. [PMID: 29475190 DOI: 10.1016/j.bodyim.2018.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 11/20/2022]
Abstract
Body dissatisfaction constitutes an important factor in the development of eating pathologies, particularly among dancers. The aim of this research was to test the factors that dancers identified as relevant to their body dissatisfaction using an exploratory mixed method design. Participants were 369 dancers from two Spanish dance conservatories. Questionnaires assessed body dissatisfaction, abnormal eating attitudes and behaviors, and risk factors to eating disorders in the dance domain. Nine factors were found; the "teacher", the "uniform", and the "mirrors" were the most common. Individuals with a greater likelihood of developing an eating disorder identified teacherś influence as a key factor in their body dissatisfaction. Specifically, ballet dancers were more likely to indicate that teachers were a negative influence compared to students in other dance genres (contemporary, flamenco, and Spanish dance). Programs to reduce negative body image and improve positive body image in dance conservatories are needed, specifically focusing on teachers.
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Affiliation(s)
- Ana García Dantas
- Psychologist at Reina Sofia Hospital, Córdoba, Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Sevilla, Spain
| | - Diana Amado Alonso
- Centre for Sport Studies, Physical Education Area, King Juan Carlos University, Faculty of Juridical and Social Sciences, Alcorcón, Madrid, Spain.
| | - Pedro Antonio Sánchez-Miguel
- Department of Didactic of Musical, Plastic and Corporal Expression, Faculty of Teacher Training, University of Extremadura, Cáceres, Spain
| | - Carmen Del Río Sánchez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Sevilla, Spain
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25
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Feragen KB, Stock NM. Factors affecting subjective appearance evaluations among patients with congenital craniofacial conditions: An application of Cash's cognitive-behavioural model of body image development. Body Image 2018; 24:124-136. [PMID: 29414145 DOI: 10.1016/j.bodyim.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/16/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Satisfaction with appearance is of central importance for psychological well-being and health. For individuals with an unusual appearance, such as congenital craniofacial anomalies (CFA), appearance evaluations could be especially important. However, few, if any papers have presented a comprehensive synthesis of the factors found to affect subjective satisfaction with appearance among children, adolescents, and adults born with a CFA. Further, only a handful of craniofacial studies have applied psychological theories or models to their findings, resulting in an overall lack of guidance for researchers in the field. This paper summarises the literature pertaining to satisfaction with appearance among those affected by CFAs, and examines the extent to which Cash's cognitive-behavioural model of body image development (2012) fits with this literature. Given the overlap between factors of interest in the field of CFAs, and in the area of body image more broadly, a closer collaboration between the two research fields is suggested.
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Affiliation(s)
| | - Nicola Marie Stock
- 'Scar Free Foundation Research Fellow' at the 'Centre for Appearance Research and The Cleft Collective', University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, United Kingdom.
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Stock NM, Feragen KB, Moss TP, Rumsey N. Toward a Conceptual and Methodological Shift in Craniofacial Research. Cleft Palate Craniofac J 2017; 55:105-111. [PMID: 34162053 DOI: 10.1177/1055665617721925] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Tim P. Moss
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
- University of the West of England, Bristol, United Kingdom
| | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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Wong Riff KWY, Tsangaris E, Goodacre TEE, Forrest CR, Lawson J, Pusic AL, Klassen AF. What Matters to Patients With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2017; 55:442-450. [DOI: 10.1177/1055665617732854] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The goal of treatment for individuals with cleft lip and/or palate (CL/P) is to improve physical, psychological, and social health. Outcomes of treatment are rarely measured from the patient’s perspective. The aim of the study was to develop a conceptual framework for a patient-reported outcome (PRO) instrument for individuals with clefts (CLEFT-Q) by developing an in-depth understanding of issues that individuals consider to be important. Design: The qualitative methodology of interpretive description was used. Setting, Participants, and Intervention: We performed 136 individual in-depth interviews with participants with clefts of any age, presenting for cleft care, across 6 countries. Parents were involved if the child was more comfortable. Interviews were audio-recorded, transcribed verbatim, and coded using constant comparison. The data were used to develop a refined conceptual framework. Results: Participants described concepts of interest in 3 top-level domains, each of which included subdomains: appearance (face, nose, nostrils, teeth, lips, jaw, cleft lip scar), health-related quality of life (psychological, social, school, speech-related distress), and facial function (speech, eating/drinking). Participants were able to describe changes over time with regard to the 3 domains. Conclusions: A conceptual framework of concepts of interest to individuals with CL/P formed the basis of the scales in the CLEFT-Q. Each subdomain represents an independently functioning scale. Understanding what matters to patients is essential in guiding PRO measurement.
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Affiliation(s)
- Karen W. Y. Wong Riff
- Division of Plastic and Reconstructive Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Elena Tsangaris
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | | | - Christopher R. Forrest
- Division of Plastic and Reconstructive Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Lawson
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Andrea L. Pusic
- Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Anne F. Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
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Intelligence and Academic Achievement of Adolescents with Craniofacial Microsomia. Plast Reconstr Surg 2017; 140:571-580. [PMID: 28841618 DOI: 10.1097/prs.0000000000003584] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The authors compared the IQ and academic achievement of adolescents with craniofacial microsomia (cases) and unaffected children (controls). Among cases, the authors analyzed cognitive functioning by facial phenotype. METHODS The authors administered standardized tests of intelligence, reading, spelling, writing, and mathematics to 142 cases and 316 controls recruited from 26 cities across the United States and Canada. Phenotypic classification was based on integrated data from photographic images, health history, and medical chart reviews. Hearing screens were conducted for all participants. RESULTS After adjustment for demographics, cases' average scores were lower than those of controls on all measures, but the magnitude of differences was small (standardized effect sizes, -0.01 to -0.3). There was little evidence that hearing status modified case-control group differences (Wald p > 0.05 for all measures). Twenty-five percent of controls and 38 percent of cases were classified as having learning problems (adjusted OR, 1.5; 95 percent CI, 0.9 to 2.4). Comparison of cases with and without learning problems indicated that those with learning problems were more likely to be male, Hispanic, and to come from lower income, bilingual families. Analyses by facial phenotype showed that case-control group differences were largest for cases with both microtia and mandibular hypoplasia (effect sizes, -0.02 to -0.6). CONCLUSIONS The highest risk of cognitive-academic problems was observed in patients with combined microtia and mandibular hypoplasia. Developmental surveillance of this subgroup is recommended, especially in the context of high socioeconomic risk and bilingual families. Given the early stage of research on craniofacial microsomia and neurodevelopment, replication of these findings is needed. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, II.
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Pedersen DA, Hageman I, Wehby GL, Christensen K. Use of Psychotropic Medications and Visits to Psychiatrists and Psychologists among Individuals with Nonsyndromic Oral Clefts: A Population-Based Cohort Study. Birth Defects Res 2017; 109:824-835. [PMID: 28402064 DOI: 10.1002/bdr2.1024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/12/2017] [Accepted: 02/04/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral clefts (OCs) are among the most common congenital malformations and can have a large impact on the life of the affected individual. Research findings regarding the psychological and psychosocial consequences of OC are inconclusive. METHODS Using Danish nationwide registers, we investigated redeemed prescriptions of psychotropic medication during 1996 to 2012 and visits to psychiatrists and psychologists during 1996 to 2011 among individuals born with nonsyndromic OC in Denmark between 1936 and 2009 and a comparison cohort of individuals without OC. This includes 8244 individuals with OC and 82,665 individuals without OC. RESULTS The Cox regression analysis revealed 12% (95% confidence interval [CI], 7 to 16%) increased risk of using any psychotropic medication for individuals with OC. When examining by cleft type, higher risks for medication use were observed in individuals with cleft lip and palate (CLP) or cleft palate (CP) only. The largest increased relative risk was found for use of antipsychotics and stimulants for individuals with CP followed by use of antipsychotics for individuals with CLP. We found increased risk of visits to psychiatrists for individuals with CP and no increased risk for visits to psychologists for either group. CONCLUSIONS This study indicates that a small group of individuals with nonsyndromic OC, in particular those with palatal involvement, have greater risk of using psychotropic medications. However, elevated use was also observed among younger individuals with cleft lip (CL) only. There seems to be only a modest increase in visits to health professionals for psychological reasons. Undiagnosed syndromes (e.g., 22q11 deletion syndrome), may, however, contribute to an overestimation of the associations. Birth Defects Research 109:824-835, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Dorthe Almind Pedersen
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Ida Hageman
- Psychiatric Department in Copenhagen, University of Copenhagen, Copenhagen University Hospital, Denmark
| | - George L Wehby
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa
| | - Kaare Christensen
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Department of Clinical Genetics, Department of Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark
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Feragen KB, Rumsey N, Heliövaara A, Boysen BM, Johannessen EC, Havstam C, Marcusson A, Nyberg J, Pedersen NH, Bogh-Nielsen J, Eyres P, Bradbury E, Semb G. Scandcleft randomised trials of primary surgery for unilateral cleft lip and Palate: 9. Parental report of social and emotional experiences related to their 5-year-old child's cleft diagnosis. J Plast Surg Hand Surg 2017; 51:73-80. [DOI: 10.1080/2000656x.2016.1254643] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Arja Heliövaara
- Department of Plastic Surgery, Cleft Palate and Craniofacial Centre, Helsinki University Central Hospital, Helsinki, Finland
| | - Betty Marie Boysen
- Copenhagen Cleft Palate Centre, University Hospital of Copenhagen, Denmark
| | | | - Christina Havstam
- Division of Speech and Language Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, University Hospital Linköping, Linkjöping, Sweden
| | - Jill Nyberg
- Division of Speech and Language Pathology, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Philip Eyres
- Dental School, University of Manchester, Manchester, UK
| | | | - Gunvor Semb
- Dental School, University of Manchester, Manchester, UK
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
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Parental, child, and adolescent experience of chronic skin conditions: A meta-ethnography and review of the qualitative literature. Body Image 2016; 19:175-185. [PMID: 27768987 DOI: 10.1016/j.bodyim.2016.10.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 09/30/2016] [Accepted: 10/02/2016] [Indexed: 11/22/2022]
Abstract
Childhood skin conditions can affect the quality of life of children, adolescents, and families. As such, paediatric dermatological conditions have been the focus of a number of qualitative studies and there is now a need to integrate the findings. A meta-ethnography was carried out with the existing 12 studies, which included nine studies examining parental experiences and three studies of child experiences. Meta-ethnographic analysis of the studies identified themes focused on the child's sense of stigmatisation and the challenges for families that arose from this. Common experiences across studies were feelings of difference relating to the appearance of the skin. The results highlight that children and adolescents can experience negative social reactions and that parents may struggle with some aspects of the physical management of the condition. The studies indicate the need to examine in more detail the psychosocial aspects of childhood skin conditions and the role played by stigmatisation.
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