REVIEW PAPER
The effects of society on the psychosocial functioning of those with a facial difference
 
More details
Hide details
1
Fordham University, New York, United States
 
 
Submission date: 2019-03-02
 
 
Final revision date: 2019-05-14
 
 
Acceptance date: 2019-05-14
 
 
Online publication date: 2019-06-05
 
 
Publication date: 2019-06-04
 
 
Health Psychology Report 2019;7(2):87-102
 
KEYWORDS
TOPICS
ABSTRACT
Adolescents with craniofacial conditions (CFCs) may experience intrapersonal and interpersonal challenges such as a greater sensitivity to attractiveness, fewer social supports, and more social withdrawal, all of which can hinder social interactions. However, there are contradictory findings as to whether adolescents with CFCs have more social problems than their peers. This article provides a framework for the social context of interper-sonal relationships for those with CFCs drawn from relevant theoretical underpinnings. The authors conducted a comprehensive literature review examining social factors that affect the interpersonal functioning of adoles-cents with CFCs. Over 35 articles were taken from the growing, but limited, research on this topic via PsychInfo and PubMed using specific search terms such as “craniofacial”, “facial dysmorphisms”, “complex facial dys-morphisms”, “interpersonal”, “psychosocial”, “social functioning”, and “adolescents” among others. Research has identified three salient barriers in social interactions: unattractive or inexpressive faces, social stigma, and societal misconceptions. The empirical studies reviewed postulate that having a facial difference does not re-sult in social dysfunction, but rather the pressures and influences of society negatively impact social function-ing. Based on the findings from this review, the authors propose a novel psychosocial model that explains the social dysfunction of adolescents with CFCs. Limitations and future interventions are also discussed.
 
REFERENCES (64)
1.
Aronson, E., Wilson, T. D., & Akert, R. M. (2010). Social psychology (7th ed.). Upper Saddle River, NJ: Pearson.
 
2.
Beaty, T. H., Wang, H., Hetmanski, J. B., Fan, Y. T., Zeiger, J. S., Liang, K. Y., Chiu, Y. F., Vander-kolk, C. A., Seifert, K. C., Wulfsberg, E. A., Raymond, G., Panny, S. R., & McIntosh, I. (2001). A case-control study of nonsyndromic oral clefts in Maryland. Annals of Epidemiology, 11, 434–442. https://doi.org/10.1016/S1047-....
 
3.
Beaune, L., Forrest, C. R., & Keith, T. (2004). Adolescents’ perspectives on living and growing up with Treacher Collins syndrome: a qualitative study. The Cleft Palate-Craniofacial Journal, 41, 343–350. https://doi.org/10.1597/02-158....
 
4.
Bemmels, H., Biesecker, B., Schmidt, J. K., Krokosky, A., Guidotti, R., & Sutton, E. J. (2013). Psy-chological and social factors in undergoing reconstructive surgery among individuals with cranio-facial conditions: An exploratory study. The Cleft Palate-Craniofacial Journal, 50, 158–167. https://doi.org/10.1597/11-127.
 
5.
Bessell, A., Brough V., Clarke, A., Harcourt, D., Moss, T. P., & Rumsey, N. (2012). Evaluation of the effectiveness of Face IT, a computer-based psychosocial intervention for disfigurement-related distress. Psychology, Health & Medicine, 17, 565–577. https://doi.org/10.1080/135485....
 
6.
Birgfeld, C. B., Luquetti, D. V., Gougoutas, A. J., Bartlett, S. P., Low, D. W., Sie, K. C., Evans, K. N., & Heike, C. L. (2011). A phenotypic assessment tool for craniofacial microsomia. Plastic and Re-constructive Surgery, 127, 313–320. https://doi.org/10.1097/PRS.0b....
 
7.
Blumer, H. (1969). Symbolic interactionism: Perspective and method. Englewood Cliffs, NJ: Prentice-Hall.
 
8.
Bogart, K. R. (2015). “People are all about appearances”: A focus group of teenagers with Moebius syndrome. Journal of Health Psychology, 20, 1579–1588. https://doi.org/10.1177/135910....
 
9.
Bogart, K. R., Tickle-Degnen, L., & Joffe, M. S. (2012). Social interaction experiences of adults with Moebius Syndrome: A focus group. Journal of Health Psychology, 17, 1212–1222. https://doi.org/10.1177/135910....
 
10.
Boltshauser, E., Ludwig, S., Dietrich, F., & Landolt, M. A. (2003). Sagittal craniosynostosis: cognitive development, behaviour, and quality of life in unoperated children. Neuropediatrics, 34, 293–300. https://doi.org/10.1055/s-2003....
 
11.
Bradbury, E. (2012). Meeting the psychological needs of patients with facial disfigurement. British Journal of Oral and Maxillofacial Surgery, 50, 193–196. https://doi.org/10.1016/j.bjom....
 
12.
Castilla, E. E., Lopez-Camelo, J. S., & Campaña, H. (1999). Altitude as a risk factor for congenital anomalies. American Journal of Medical Genetics, 86, 9–14. https://doi.org/10.1002/(SICI)....
 
13.
Cembrano, J. R., De Vera, J. S., Joaquino, J. B., Ng, E. F., Tongson, T. L., Manalo, P. D., Fernan-dez, G. C., & Encarnacion, R. C. (1995). Familial risk of recurrence of clefts of the lip and palate. Philippine Journal of Surgical Specialties, 50, 37–40.
 
14.
Christensen, K., Schmidt, M. M., Vaeth, M., & Olsen, J. (1995). Absence of an environmental effect on the recurrence of facial-cleft defects. The New England Journal of Medicine, 333, 161–164. https://doi.org/10.1056/NEJM19....
 
15.
Chung, C. S., Mi, M. P., & Beechert, A. M. (1987). Genetic epidemiology of cleft lip with or without cleft palate in the population of Hawaii. Genetic Epidemiology, 4, 415–423. https://doi.org/10.1002/gepi.1....
 
16.
Cohen, M. M. Jr. (2002). Malformations of the craniofacial region: Evolutionary, embryonic, genetic, and clinical perspectives. American Journal of Medical Genetics, 115, 245–268. https://doi.org/10.1002/ajmg.1....
 
17.
Crerand, C. E., Sarwer, D. B., Kazak, A. E., Clarke, A., & Rumsey, N. (2017). Body image and quality of life in adolescents with craniofacial conditions. The Cleft Palate-Craniofacial Journal, 54, 2–12. https://doi.org/10.1597/15-167.
 
18.
Edwards, T. C., Patrick, D. L., Topolski, T. D., Aspinall, C. L., Mouradian, W. E., & Speltz, M. L. (2005). Approaches to craniofacial-specific quality of life assessment in adolescents. The Cleft Palate-Craniofacial Journal, 42, 19–24. https://doi.org/10.1597/03-097....
 
19.
Edwards, T. C., Topolski, T. D., Kapp-Simon, K. A., Aspinall, C. L., & Patrick, D. L. (2011). What dif-ference can a minute make? Social skills and first impressions of youth with craniofacial differ-ences. The Cleft Palate-Craniofacial Journal, 48, 91–97. https://doi.org/10.1597/08-204.
 
20.
Feragen, K. B., Borge, A. I., & Rumsey, N. (2009). Social experience in 10-year-old children born with a cleft: Exploring psychosocial resilience. The Cleft Palate-Craniofacial Journal, 4, 65–74. https://doi.org/10.1597/07-124....
 
21.
Feragen, K. B., & Stock, N. M. (2017). Psychological adjustment to craniofacial conditions (excluding oral clefts): A review of the literature. Psychology & Health, 32, 253–288. https://doi.org/10.1080/088704....
 
22.
Fischer, S., Tovetjarn, R., Maltese, G., Sahlin, P. E., Tarnow, P., & Kolby, L. (2014). Psychosocial conditions in adults with Crouzon syndrome: A follow-up study of 31 Swedish patients. Journal of Plastic Surgery and Hand Surgery, 48, 244–247. https://doi.org/10.3109/200065....
 
23.
García, A. M., Fletcher, T., Benavides, F. G., & Orts, E. (1999). Parental agricultural work and selected congenital malformations. American Journal of Epidemiology, 149, 64–74. Retrieved from https://academic.oup.com/aje/a....
 
24.
Goffman, E. (1959). The presentation of self in everyday life. New York, NY: Anchor Books.
 
25.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York, NY: Simon & Schuster, Inc.
 
26.
Hemmesch, A. R., Tickle-Degnen, L., & Zebrowitz, L. A. (2009). The influence of facial masking and sex on older adults’ impressions of individuals with Parkinson’s disease. Psychology and Aging, 24, 542–549. https://doi.org/10.1037/a00161....
 
27.
Hunt, O., Burden, D., Hepper, P., Stevenson, M., & Johnston, C. (2006). Self-reports of psychosocial functioning among children and young adults with cleft lip and palate. The Cleft Palate-Craniofacial Journal, 43, 598–605. https://doi.org/10.1597/05-080.
 
28.
Joachim, G., & Acorn, S. (2003). Life with a rare chronic disease: The scleroderma experience. Journal of Advanced Nursing, 42, 598–606. https://doi.org/10.1046/j.1365....
 
29.
Kapp-Simon, K. A., McGuire, D. E., Long, B. C., & Simon, D. J. (2005). Addressing quality of life issues in adolescents: Social skills interventions. The Cleft Palate-Craniofacial Journal, 42, 45–50. https://doi.org/10.1597/03-097....
 
30.
Klingenberg, C. P., Wetherill, L., Rogers, J., Moore, E., Ward, R., Autti-Rämö, I., Fagerlund, Å., Ja-cobson, S. W., Robinson, L.K., Hoyme, H. E., Mattson, S. N., Li, T. K., Riley, E. P., Foroud, T., & CIFASD Consortium. (2010). Prenatal alcohol exposure alters the patterns of facial asymmetry. Alcohol, 44, 649–657. https://doi.org/10.1016/j.alco....
 
31.
Little, J., Cardy, A., & Munger, R. G. (2004). Tobacco smoking and oral clefts: A meta-analysis. Bulle-tin of the World Health Organization, 82, 213–218. http://dx.doi.org/10.1590/S004....
 
32.
Loffredo, L. C., Souza, J. M., Freitas, J. A., & Mossey, P. A. (2001). Oral clefts and vitamin supple-mentation. The Cleft Palate-Craniofacial Journal, 38, 76–83. https://doi.org/10.1597/1545-1....
 
33.
Macgregor, F. C. (1990). Facial disfigurement: Problems and management of social interaction and implications for mental health. Aesthetic Plastic Surgery, 14, 249–257. https://doi.org/10.1007/BF0157....
 
34.
Masnari, O., Schiestl, C., Rössler, J., Gütlein, S. K., Neuhaus, K., Weibel, L., Meuli, M., & Landolt, M. A. (2013). Stigmatization predicts psychological adjustment and quality of life in children and adolescents with a facial difference. Journal of Pediatric Psychology, 38, 162–172. https://doi.org/10.1093/jpepsy....
 
35.
McVee, M. B., Dunsmore, K., & Gavelek, J. R. (2005). Schema theory revisited. Review of Educational Research, 75, 531–566. https://doi.org/10.3102/003465....
 
36.
Murray, J. C. (2002). Gene/environment causes of cleft lip and/or palate. Clinical Genetics, 61, 248–256. https://doi.org/10.1034/j.1399....
 
37.
Natsume, N., Kawai, T., Ogi, N., & Yoshida, W. (2000). Maternal risk factors in cleft lip and palate: Case control study. The British Journal of Oral & Maxillofacial Surgery, 38, 23–25. https://doi.org/10.1054/bjom.1....
 
38.
Patrick, D. L., Topolski, T. D., Edwards, T. C., Aspinall, C. L., Kapp-Simon, K. A., Rumsey, N. J., Strauss, R. P., & Thomas, C. R. (2007). Measuring the quality of life of youth with facial differ-ences. The Cleft Palate-Craniofacial Journal, 44, 538–547. https://doi.org/10.1597/06-072....
 
39.
Pierpont, E. I., Semrud-Clikeman, M., & Pierpont, M. E. (2017). Variability in clinical and neuropsycho-logical features of individuals with MAP2K1 mutations. American Journal of Medical Genetics Part A, 173, 452–459. https://doi.org/10.1002/ajmg.a....
 
40.
Rahman, J., & Rahman, S. (2019). The utility of phenomics in diagnosis of inherited metabolic disor-ders. Clinical Medicine, 19, 30–36. https://doi.org/10.7861/clinme....
 
41.
Ratner, C. (1999). Three approaches to cultural psychology: A critique. Cultural Dynamics, 11, 7–31. https://doi.org/10.1177/092137....
 
42.
Roberts, R. M., & Shute, R. H. (2012). A prospective study of coping and adjustment in adolescents with craniofacial conditions. Children’s Health Care, 41, 111–128. https://doi.org/10.1080/027396....
 
43.
Robinson, E., Rumsey, N., & Patridge, J. (1996). An evaluation of the impact of social interaction skills training for facially disfigured people. British Journal of Plastic Surgery, 49, 281–289. Re-trieved from http://www.jprasurg.com/articl....
 
44.
(96)90156-3/pdf.
 
45.
Romitti, P. A., Sun, L., Honein, M. A., Reefhuis, J., Correa, A., & Rasmussen, S. A. (2007). Maternal periconceptional alcohol consumption and risk of orofacial clefts. American Journal of Epidemiolo-gy, 166, 775–785. https://doi.org/10.1093/aje/kw....
 
46.
Roosenboom, J., Hens, G., Mattern, B. C., Shriver, M. D., & Claes, P. (2016). Exploring the underly-ing genetics of craniofacial morphology through various sources of knowledge. BioMed Research International, ID 3054578. https://doi.org/10.1155/2016/3....
 
47.
Rowland, M. P., & Bell, E. C. (2012). Measuring attitudes of sighted college students towards blind-ness. Journal of Blindness Innovation and Research, 2. https://doi.org/10.5241/2F2-24.
 
48.
Rumsey, N., & Harcourt, D. (2005). The psychology of appearance. London: Oxford University Press.
 
49.
Shaw, G. M., Lammer, E. J., Wasserman, C. R., O’Malley, C. D., & Tolarova, M. M. (1995). Risks of orofacial clefts in children born to women using multivitamins containing folic acid periconception-ally. Lancet, 346, 393–396. https://doi.org/10.1016/S0140-....
 
50.
Snyder, K. A., & Pearse, W. (2010). Crisis, social support, and the family response: Exploring the narratives of young breast cancer survivors. Journal of Psychosocial Oncology, 28, 413–431. https://doi.org/10.1080/073473....
 
51.
Spinelli, C. G. (2004). Dealing with cancer in the classroom: The teacher’s role and responsibilities. Teaching Exceptional Children, 36, 14–21. Retrieved from http://journals.sagepub.com/do....
 
52.
Strobel, L., & Renner, G. (2016). Quality of life and adjustment in children and adolescents with Moebius syndrome: Evidence for specific impairments in social functioning. Research in Develop-mental Disabilities, 53, 178–188. https://doi.org/10.1016/j.ridd....
 
53.
Tickle-Degnen, L., & Lyons, K. D. (2004). Practitioners’ impressions of patients with Parkinson’s dis-ease: The social ecology of expressive mask. Social Science & Medicine, 58, 603–614. https://doi.org/10.1016/S0277-....
 
54.
Tolarova, M., & Harris, J. (1995). Reduced recurrence of orofacial clefts after periconceptional sup-plementation with high-dose folic acid and multivitamins. Teratology, 51, 71–78. https://doi.org/10.1002/tera.1....
 
55.
Topolski, T. D., Edwards, T. C., & Patrick, D. L. (2005). Quality of life: How do adolescents with facial differences compare with other adolescents? The Cleft Palate-Craniofacial Journal, 42, 19–24. https://doi.org/10.1597/03-097....
 
56.
Vygotsky, L. S. (1978). Mind in society. Cambridge, MA: Harvard University Press.
 
57.
Warschausky, S., Kay, J. B., Buchman, S., Halberg, A., & Berger, M. (2002). Health-related quality of life in children with craniofacial anomalies. Plastic and Reconstructive Surgery, 110, 409–414. Re-trieved from https://insights.ovid.com/pubm....
 
58.
Wilcox, A. J., Lie, R. T., Solvoll, K., Taylor, J., McConnaughey, D. R., Abyholm, F., Vindenes, H., Vollset, S. E., & Drevon, C. A. (2007). Folic acid supplements and risk of facial clefts: National population based case-control study. British Medical Journal, 334, 464. https://doi.org/10.1136/bmj.39....
 
59.
World Health Organization. (2003). Global registry and database on craniofacial anomalies: Report of a WHO registry meeting on craniofacial anomalies (3rd ed.). Bauru, Brazil: WHO.
 
60.
Wyszynski, D. F., & Beaty, T. H. (1996). Review of the role of potential teratogens in the origin of hu-man nonsyndromic oral clefts. Teratology, 53, 309–317. https://doi.org/10.1002/(SICI)....
 
61.
(199605)53:53.0.CO;2-W.
 
62.
Yoo, G. J., Aviv, C., Levine, E. G., Ewing, C., & Au, A. (2010). Emotion work: Disclosing cancer. Support Care Cancer, 18, 205–215. https://doi.org/10.1007/s00520....
 
63.
Zebrowitz, L. A., & Montepare, J. M. (2008). Social psychological face perception: Why appearance matters. Social and Personality Psychology Compass, 2, 1497–1517. https://doi.org/10.1111/j.1751....
 
64.
Zulauf, C., Spinelli, T., & Rosenberg, J. (2018). Advocating for the child: The role of pediatric psy-chology for children with cleft lip and/or palate. Plastic Surgical Nursing, 38, 114–120. https://doi.org/10.1097/PSN.00....
 
Copyright: © Institute of Psychology, University of Gdansk This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2353-5571
ISSN:2353-4184
Journals System - logo
Scroll to top