To analyze personality (Big Five Model) and cognitive–emotional variables in children and adolescents with a cleft lip/palate (s) in comparison to an equivalent peer sample without an orofacial cleft.
Design:
Cross-sectional study with data collected using self-reported questionnaires over 2 years.
Setting:
Data were collected during visits to health center dental clinics.
Patients:
Children and adolescents (aged 8-18 years) with nonsyndromic CL/P (n = 60) and without a cleft (n = 60).
Method:
Patients completed questionnaires with assistance as needed from a member of the research team.
Main Outcome Measures:
Children’s Perceived Self-Efficacy, Cognitive Emotion Regulation Questionnaire (child version), Big Five Questionnaire for Children, and Alexithymia Questionnaire for Children.
Results:
When accounting for age, children with CL/P had normative self-efficacy and cognitive–emotional regulation strategies, with the protective factor of significantly lower rumination than peers. Children with CL/P were significantly lower on the Big Five personality areas of conscientiousness, openness to experience, extraversion, and agreeableness along with significantly higher neuroticism. They were similarly significantly higher than peers for alexithymia.
Conclusion:
Children with CL/P showed strengths in self-efficacy typical of peers and less use of some maladaptive coping strategies; however, they also had higher levels of alexithymia and risk factors associated with the Big Five Model of personality. Strategies may be clinically useful that maximize areas of strength to support children with CL/P in expressing their emotions to reduce alexithymia, coping with of negative affect, and building assertiveness.
AaronRVFisherEAPalermoTM. Alexithymia in adolescents with and without chronic pain. Rehabil Psychol. 2019;64(4):469–474.
2.
AjamiSTorabyFShavakhiMEslamiN. The impact of type-d personality on oral health-related quality of life in cleft lip and palate adolescents. J Craniofac Surg. 2018;29(2):289–292.
3.
AndersonDMKeithJNovakPD. Mosby’s Medical Dictionary. 6th ed. MosbyA, ed. Harcourt Health Science Company; 2002.
4.
AndrésMLRichaud De MinziMCCastañeirasCCanet-JuricLRodríguez-CarvajalR. Neuroticism and depression in children: the role of cognitive emotion regulation strategies. J Genet Psychol. 2016;177(2):55–71.
5.
ArmumPChellappanK. Social and emotional self-efficacy of adolescents: measured and analysed interdependencies within and across academic achievement level. Int J Adolesc Youth. 2016;21(3):279–288.
6.
BacchiniDMagliuloF. Self-image and perceived self-efficacy during adolescence. J Youth Adolesc. 2003;32(5):337–349.
7.
BanduraA.Self-efficacy. In: The Corsini Encyclopedia of Psychology. John Wiley & Sons Inc. 2010;72(1):801–804.
8.
BanduraA. Multidimensional Scales of Perceived Self-Efficacy. Stanford University; 1990.
9.
BarbaranelliCCapraraGRabascaA. Manuale del BFQ-C. Big Five Questionnaire Children. OS Organizazioni Speciali; 1998.
10.
BarlowJEllardD.Psycho-educational interventions for children with chronic disease, parents and siblings: an overview of the research evidence base. Child Care Health Dev. 2004;30(6), 637–645.
11.
BerryLAWittPDMarshJLPilgramTKEderRA. Personality attributions based on speech samples of children with repaired cleft palates. Cleft Palate Craniofac J. 1997;34(5):385–389.
12.
BettsJGulloneESabura AllenJ.An examination of emotion regulation, temperament, and parenting style as potential predictors of adolescent depression risk status: a correlational study. Br J Dev Psychol. 2009;27(2):473–485.
13.
BorghuisJBleidornWSijtsmaKBranjeSMeeusWHJDenissenJJA. Longitudinal associations between trait neuroticism and negative daily experiences in adolescence. J Pers Soc Psychol. 2019;118(2):348–363.
14.
BroderHLWilson-GendersonMSischoL. Examination of a theoretical model for oral health-related quality of life among youths with cleft. Am J Public Health. 2014;104(5):865–871.
15.
Carrasco OrtizMÁdel Barrio GándaraMV. Evaluación de la autoeficacia en niños y adolescentes. Psicothema. 2002;14(2):323–332.
16.
CastañedaEPeñacobaC.Regulación emocional en la infancia. Relación con la personalidad, la calidad de vida y la regulación emocional paterna. Panam J Neuropsychol. 2017;11(3):113–134.
17.
CrerandCEConradALAlbertMCrilly BellucciCHeppnerCESheikhFWoodardSKapp-SimonKA. The Americleft psychosocial outcomes project: a multicenter approach to advancing psychosocial outcomes for youth with cleft lip and palate. Clin Pract Pediatr Psychol. 2017;5(1):65–76.
18.
De OliveiraRLBDe Santana SantosTDe Almeida TeixeiraJLMartins-FilhoPRSDa SilvaLCF. Health-related quality of life patients with a cleft lip and/or palate. J Craniofac Surg. 2015;26(8):2315–2319.
19.
Del BarrioMCarrascoMHolgadoF. BFQ-NA Cuestionario De Los Cinco Grandes Para Niños Y Adolescentes (Adaptación A La Población Española). Tea Ediciones; 2006.
20.
DemirTKaracetinGBaghakiSAydinY. Psychiatric assessment of children with nonsyndromic cleft lip and palate. Gen Hosp Psychiatry. 2011;33(6):594–603.
21.
EisenbergNMorrisAS. Children’s emotion-related regulation. In: BensonJ, ed. Advances in Child Development and Behavior. Elsevier Masson SAS; 2003.
22.
EndlerNS. Multidimensional Interactionism: Stress, Anxiety, and Coping. Psychology Press. 2002.
23.
EndrigaMCJordanJRSpeltzML. Emotion self-regulation in preschool-aged children with and without orofacial clefts. J Dev Behav Pediatr. 2003;24(5):336–344.
24.
FadeyibiIOCokerOAZacchariahMPFasaweAAdemiluyiSA. Psychosocial effects of cleft lip and palate on Nigerians: the Ikeja-Lagos experience. J Plast Surg Hand Surg. 2012;46(1):13–18.
25.
FeragenKBBorgeAIH. Peer harassment and satisfaction with appearance in children with and without a facial difference. Body Image. 2010;7(2):97–105.
26.
FeragenKBKvalemILRumseyNBorgeAIH.Adolescents with and without a facial difference: the role of friendships and social acceptance in perceptions of appearance and emotional resilience. Body Image. 2010;7(4):271–279.
27.
FeragenKBSærvoldTKAuknerRStockNM. Speech, language, and reading in 10-year-olds with cleft: associations with teasing, satisfaction with speech, and psychological adjustment. Cleft Palate Craniofac J, 2017;54(2):153–165.
28.
FeragenKBStockNMKvalemIL. Risk and protective factors at age 16: psychological adjustment in children with a cleft lip and/or palate. Cleft Palate Craniofac J. 2015;52(5):555–573.
29.
GarnefskiNRieffeCJellesmaFTerwogtMMKraaijV. Cognitive emotion regulation strategies and emotional problems in 9-11-year-old children: the development of an instrument. Eur Child Adolesc Psychiatry. 2007;16(1):1–9.
30.
GasslingVKesslerHKleinMODetjenAMKoosBLimbrecht-EcklundtKTraueHCWiltfangJGerberWD. Normal emotion regulation in adults with cleft lip and palate: an exploratory study. J Craniomaxillofac Surg. 2014;42(7):1271–1276.
31.
GhiggiaARomeoATesioVDi TellaMColonnaFGeminianiGCFusaroECastelliL. Alexithymia and depression in patients with fibromyalgia: when the whole is greater than the sum of its parts. Psychiatry Res. 2017;255(May):195–197.
32.
GlenerADAlloriACShammasRLCarlsonARPienIJAylsworthASMeyerRPimentaLStraussRWatkinsS, et al.A Population-Based Exploration of the Social Implications associated with cleft lip and/or Palate. Plast Reconstr Surg Glob Open. 2017;5(6):1–7.
33.
GreshamDGulloneE. Emotion regulation strategy use in children and adolescents: the explanatory roles of personality and attachment. Pers Individ Dif. 2012;52(5):616–621.
34.
HayesAF. Introduction to Mediation, Moderation, and Conditional Process Analysis Second Edition: A Regression-Based Approach. Guilford Publications; 2017.
35.
JohnsALBavaL. Psychosocial functioning of children in a craniofacial support group. Cleft Palate Craniofac J. 2019;56(3):340–348.
36.
KesslerHSchwarzeMFilipicSTraueHCVon WietersheimJ. Alexithymia and facial emotion recognition in patients with eating disorders. Int J Eat Disord. 2006;39(3):245–251.
37.
KingGAShultzIZSteelKGilpinMCathersT. Self-evaluation and self-concept of adolescents with physical disabilities. Am J Occup Ther. 1993;47(2):132–140.
38.
Leopoldo-RodadoMPantoja-PertegalFBelmonte-CaroRGarcia-PerlaA. Quality of life in early age Spanish children treated for cleft lip and/or palate: a case-control study approach. Clin Oral Investig. 2020.
39.
LópezECPuenteCPMorenoSB. Is there any relation between alexithymia in parents and children? Effects on children’s quality of life. Electron J Res Educ Psychol. 2018;16(44):103–126.
40.
LuYHoRLimTKKuanWSen GohDYTMahadevanMSimTBNgTPVan BeverHPS. Psychiatric comorbidities in asian adolescent asthma patients and the contributions of neuroticism and perceived stress. J Adolesc Heal. 2014;55(2):267–275.
41.
LuléDSchulzeUMEBauerKSchöllFMüllerS.FladungAKUttnerI. Anorexia nervosa and its relation to depression, anxiety, alexithymia and emotional processing deficits. Eat Weight Disord. 2014;19(2):209–216.
42.
MannLSWiseTNTrinidadAKohanskiR. Alexithymia, affect recognition, and the five-factor model of personality in normal subjects. Psychol Rep. 1994;74(2):563–567.
43.
McCraeRRCostaPT. A five-factor theory of personality. In: PervinLJonhO, eds. Handbook of Personality. 2nd ed. Guilford Press. 1999:139–156.
44.
MoorjaniJDIssacC. Neurotic manifestations in adolescents with thalassemia major. Indian J Pediatr. 2006;73(7):603–607.
45.
MuñozJMCastilloMAS. Self-Esteem, extraversion and resentment as predictors of subjective well-being. Univ Psychol, 2019;18(1):1–18.
46.
MurisPMeestersCDiederenR. Psychometric properties of the Big Five Questionnaire for Children (BFQ-C) in a Dutch sample of young adolescents. Pers Individ Dif. 2005;38(8):1757–1769.
47.
PastorelliCCapraraGVBarbaranelliCRolaJRozsaSBanduraA.The structure of Children’s Perceived Self-Efficacy: a cross-national study. Eur J Psychol Assess. 2001;17(2):87–97.
48.
PeñacobaCCastañedaEFernándezJPocinhoR. Alexithymia questionnaire for children (AQC): psychometric properties, factor structure and initial validation in a Spanish sample. Int J Psychol Neurosci. 2016;2(2):1–21.
49.
PerssonMAnianssonGBeckerMSvenssonH. Self-concept and introversion in adolescents with cleft lip and palate. Scand J Plast Reconstr Surg Hand Surg. 2002;36(1):24–27.
50.
PinquartMPfeifferJP. Associations of extroversion and parental overprotection with forming relationships with peers among adolescents with and without visual impairments. J Vis Impair Blind. 2011;105(2):96–107.
51.
PiombinoPRuggieroFOrabonaGDAScopellitiDBianchiADe SimoneFCarnevaleNBrancatiFIengoMGrassiaMG, et al.Development and validation of the quality-of-life adolescent cleft questionnaire in patients with cleft lip and palate. J Craniofac Surg. 2014;25(5):1757–1761.
52.
PolloniLGregoriDFerruzzaEOricoliCLazzarottoFBonaguroRTonioloACelegatoNMuraroA. Alexithymia in food-allergic versus healthy children and young adults. J Health Psychol. 2017;22(2):228–236.
53.
QuintoRMSampognaFFaniaLCicconeDFusariRMastroeniSIaniLAbeniD.Alexithymia, psychological distress, and social impairment in patients with hidradenitis suppurativa. Dermatol. 2019; November 19:1–8.
54.
RieffeCOosterveldPTerwogtMM. An alexithymia questionnaire for children: factorial and concurrent validation results. Pers Individ Dif. 2006;40(1):123–133.
55.
RothbartMK. Temperament, development, and personality. Curr Dir Psychol Sci. 2007;16(4):207–212.
56.
RuffRRSischoLBroderH. Resiliency and socioemotional functioning in youth receiving surgery for orofacial anomalies. Community Dent Oral Epidemiol. 2016;44(4):371–380.
57.
SmithTEMartelMM. Trait-based profiles of ADHD in adolescents and young adults. J Clin Child Adolesc Psychol. 2019;48(3):440–454.
58.
SnyderHPopeAW. Psychosocial adjustment in children and adolescents with a craniofacial anomaly: diagnosis-specific patterns. Cleft Palate Craniofac J. 2010;47(3):264–272.
59.
StockNMHammondVHearstDOwenTEdwardsZRidleyMRumseyN. Achieving consensus in the measurement of psychological adjustment to cleft lip and/or palate at age 8+ years. Cleft Palate Craniofac J. 2020;57(6):746–752.
60.
StockNMRidleyM. Young person and parent perspectives on the impact of cleft lip and/or palate within an educational setting. Cleft Palate Craniofac J. 2018;55(4):607–614.
61.
StrickhouserJEZellEKrizanZ. Does personality predict health and well-being? A metasynthesis. Heal Psychol. 2017;36(8):797–810.
62.
TaylorGJBagbyRM. The alexithymia personality dimension. In: WidigerT, ed. The Oxford Handbook of Personality Disorders. Oxford University Press. 2012:648–673.
63.
TianLJiangSHuebnerES. The big two personality traits and adolescents’ complete mental health: the mediation role of perceived school stress. Sch Psychol Q. 2019;34(1):32–42.
64.
Van Der PlasEKoscikTRConradALMoserDJNopoulosP. Social motivation in individuals with isolated cleft lip and palate. J Clin Exp Neuropsychol. 2013;35(5):489–500.
65.
Yáñez-VicoRMIglesias-LinaresAGómez-MendoITorres-LagaresDGonzález-MolesMÁGutierrez-PérezJLSolano-ReinaE. A descriptive epidemiologic study of cleft lip and palate in Spain. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(suppl 5):S1–S4.
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