Psychosocial adjustment in children and adolescents with cleft lip and/or palate : exploring risk and protective factors

Sociocultural norms may render individuals with a facial difference such as a cleft lip and/or palate more noticeable and possibly more socially vulnerable. Given the importance of appearance satisfaction and social experiences for psychological health, a better understanding of risk and protective factors when the child is born with a cleft is warranted. This dissertation is based on a cross-sectional sample of 661 children and adolescents with a cleft. The key findings were that whether the cleft was objectively visible in the face or not, did not explain the variation in psychosocial experiences or emotional well-being, in contrast to the subjective measures of appearance. Associations between social experiences and appearance evaluations were clear. The results suggest that appearance satisfaction may be enhanced by social experiences such as friendships, while dissatisfaction with appearance may be exacerbated by negative experiences such as peer harassment and teasing. Adolescent boys with a visible cleft reported significantly better psychological adjustment than boys with no facial difference, suggesting protective factors in the presence of a facial difference. Longitudinal research will be needed in order to confirm the directionality of the relations between the variables reported in this dissertation