To assess rates of psychosocial adjustment problems in adolescents with craniofacial anomalies (CFAs) and to evaluate the correspondence between adolescent and parent reports of adjustment.
Design
Retrospective chart review.
Setting
Reconstructive plastic surgery department in urban medical center.
Participants
Sixty-four adolescents aged 14 to 18 years with CFAs and their parents.
Main Outcome Measures
Child Behavior Checklist, Youth Self-Report.
Results
Adolescent and parent reports were compared with published norms. Adolescents with CFAs did not differ from norms on rates of self-reported problems in the clinical range. Parents of sons and daughters with CFAs reported elevations in the clinical range for deficits in social and scholastic competence; parents of daughters also reported higher clinical rates of withdrawn and somatic problems. Correlations between adolescent and parent reports were generally higher than seen in norms, especially for boys. Parents and adolescents did not differ in reported rates of problems in the clinical range.
Conclusions
Adolescents with CFAs showed elevated risk for problems with academics and peer relationships; there was limited evidence for clinical levels of other adjustment problems. When parent and adolescent reports differed, parents reported more problems.
AchenbachT.M.. Manual for the Child Behavior Checklist and 1991 Child Behavior Profile.Burlington: University of Vermont Press;1991a.
2.
AchenbachT.M.. Manual for the Youth Self-Report and 1991 YSR Profile.Burlington: University of Vermont Press;1991b.
3.
AchenbachT.M.. Integrative Guide for the 1991 CBCL/4–18, YSR, and TRF Profiles.Burlington: University of Vermont Press;1991c.
4.
AchenbachT.M., McConaughyS.H., HowellC.T.. Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity.Psychol Bull.1987; 101: 213–232.
5.
BrantleyH.T., CliffordE.. Maternal and child locus of control and field-dependence in cleft palate children.Cleft Palate J.1979; 16: 183–187.
6.
BroderH.L., RichmanL.C., MathesonP.B.. Learning disability, school achievement, and grade retention among children with cleft: a two-center study.Cleft Palate Craniofac J.1998; 35: 127–131.
7.
BroderH.L., SmithF.B., StraussR.P.. Effects of visible and invisible orofacial defects on self-perception and adjustment across developmental eras and gender.Cleft Palate Craniofac J.1994; 31: 429–436.
8.
CohenJ., CohenP.. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences.Hillsdale, NJ: Erlbaum;1983.
9.
ColemanJ.M.. Handicapped labels and instructional segregation: influences on children's self-concepts versus the perceptions of others.Learning Disabil Q.1983; 6: 3–11.
10.
EliasonM., RichmanL.. Behavioral characteristics of cleft children related to age, sex, and cleft type. Paper presented at the American Cleft Palate Association; 1987; San Antonio, Texas.
11.
EndrigaM., Kapp-SimonK.. Psychological issues in craniofacial care: state of the art.Cleft Palate Craniofac J.1999; 36: 3–11.
12.
GreenS.B., SalkindN.J., AkeyT.M.. Two related samples tests: the McNemar, Sign, and Wilcoxon tests. In: RobertsN., JanzowP., SignorettiN., KalishI., RottinoM., eds. Using SPSS for Windows: Analyzing and Understanding Data.Englewood Cliffs, NJ: Prentice Hall;1997: 435–445.
HarterS.. The Construction of Self.New York: Guilford Press;1999.
15.
HarveyD., GreenwayP.. Congruence between mother and handicapped child's view of the child's view of the child's sense of adjustment.Exceptional Child.1982; 29: 111–116.
16.
HatfieldE., SprecherE.. Mirror, Mirror: The Importance of Looks in Everyday Life.New York: State University of New York Press;1986.
17.
Kapp-SimonK., McGuireD.. Observed social interaction patterns in adolescents with and without craniofacial conditions.Cleft Palate Craniofac J.1997; 34: 380–384.
18.
KashaniJ.H., KonigP., ShepperdJ.A., WilfleyD., MorrisD.A.. Psychopathology and self-concept in asthmatic children.J Pediatr Psychol.1988; 13: 509–520.
19.
KlinnertM.D., McQuaidE.L., McCormickD., AdinoffA.D., BryantN.E.. A multimethod assessment of behavioral and emotional adjustment in children with asthma.J Pediatr Psychol.2000; 25: 35–46.
20.
La GrecaA.M.. Social consequences of pediatric conditions: fertile area for future investigation and intervention.J Pediatr Psychol.1990; 15: 285–307.
21.
La GrecaA.M., LamanekK.L.. Asssessment as a process in pediatric psychology.J Pediatr Psychol.1996; 21: 137–151.
22.
LangloisJ.H., StephanC.W.. Beauty and the beast: the role of physical attractiveness in the development of peer relations and social behavior. In: BrehmS.S., KassinS.M., GibbonsF.X., eds. Developmental Social Psychology.New York: Oxford University Press;1981: 152–168.
23.
LeonardB.J., BrustJ.D., AbrahamsG., SielaffB.. Self-concept of children and adolescents with cleft lip and/or palate.Cleft Palate Craniofac J.1991; 28: 347–353.
24.
MacgregorF.C.. Facial disfigurement: problems and management of social interaction and implications for mental health.Aesthetic Plast Surg.1990; 14: 249–257.
25.
MastenA.S., CoatsworthJ.D.. The development of competence in favorable and unfavorable environments: lessons from research on successful children.Am Psychol.1998; 53: 205–220.
26.
MunroI.R.. A description of craniofacial anomalies: the mechanism and rationale of surgery. In: EderR.A., ed. Craniofacial Anomalies: Psychological Perspectives.New York: Springer-Verlag;1995: 3–21.
27.
PeterJ.P., ChinskyR.R., FisherM.. Sociological aspects of cleft palate adults: III. Vocational and economic aspects.Cleft Palate J.1975; 12: 193–199.
28.
PopeA.W., SnyderH.T.. Psychosocial adjustment in children and adolescents with a craniofacial anomaly: age and sex patterns.Cleft Palate Craniofac J.2005; 42: 349–354.
29.
PruzinskyT.. Social and psychological effects of major craniofacial deformity.Cleft Palate Craniofac J.1992; 29: 578–584.
30.
RadcliffeJ., BennettD., KazakA.E., FoleyB., PhillipsP.C.. Adjustment in childhood brain tumor survival: child, mother, and teacher report.J Pediatr Psychol.1996; 21: 529–539.
31.
ReisH.T., HodginsH.S.. Reactions to craniofacial disfigurement: lessons from the physical attractiveness and stigma literatures. In: EderR.A., ed. Craniofacial Anomalies: Psychological Perspectives.New York: Springer-Verlag;1995: 177–198.
32.
Reiter-PurtillJ., NollR.B.. Peer relationships of children with chronic illness. In: RobertsM.C., ed. Handbook of Pediatric Psychology.New York: Guilford Press;2003: 176–197.
33.
RichmanL.C.. Self-reported social, speech, and facial concerns and personality adjustment of adolescents with cleft lip and palate.Cleft Palate J.1983; 20: 108–112.
RichmanL.C., HolmesC.S., EliasonM.J.. Adolescents with cleft lip and palate: self-perceptions of appearance and behavior related to personality adjustment.Cleft Palate J.1985; 22: 93–96.
36.
RubinK.H., WilkinsonM.. Peer rejection and social isolation in childhood: a conceptually inspired research agenda for children with craniofacial handicaps. In EderR.A., ed. Craniofacial Anomalies: Psychological Perspectives.New York: Springer-Verlag; 1995: 158–176.
37.
Seiffge-KrenkeI., KollmarF.. Discrepancies between mothers’ and fathers’ perceptions of sons’ and daughters’ problem behavior: a longitudinal analysis of parent-adolescent agreement on internalizing and externalizing problem behavior.J Child Psychol Psychiatry.1998; 39: 687–697.
38.
SpeltzM.L., ArmsdenG.C., ClarrenS.S.. Effects of craniofacial birth defects on maternal functioning postinfancy.J Pediatr Psychol.1990; 15: 177–196.
39.
SpeltzM.L., GalbreathH., GreenbergM.T.. A developmental framework for psychosocial research on young children with craniofacial anomalies. In: EderR.A., ed. Developmental Perspectives on Craniofacial Problems.New York: Springer-Verlag;1995: 258–286.
40.
SpeltzM.L., RichmanL.. Progress and limitations in the psychological study of craniofacial anomalies [editorial].J Pediatr Psychol.1997; 22: 433–438.
41.
VerhulstF.C., van der EndeJ.. Agreement between parents’ reports and adolescents’ self-reports of problem behavior.J Child Psychol Psychiatry.1992; 33: 1011–1023.
42.
WallanderJ.L., ThompsonR.J., Alriksson-SchmidtA.. Psychosocial adjustment of children with chronic physical conditions. In: RobertsM.C., ed. Handbook of Pediatric Psychology.New York: Guilford Press;2003: 141–158.
