Abstract
Objective:To investigate the influence of gender, dispositional optimism, and coping strategies on appearance-related distress among individuals with unilateral cleft lip and palate (UCLP).Design:Cross-sectional design with self-report questionnaires analyzed primarily with Spearman correlations (r s) and multivariate regression analyses.Setting:A tertiary cleft center in Sweden.Participants:Eighty individuals with UCLP born 1966 to 1986. The mean age for men (n = 50) and women (n = 30) was 38.8 and 37.4 years, respectively.Main Outcome Measures:The Derriford Appearance Scale 24 measured appearance-related distress, the Life Orientation Test–Revised, short version measured dispositional optimism and pessimism, and the Coping Orientation to Problems Experienced, short version included 14 coping strategies.Results:Women had higher appearance-related distress than men, which was significantly (P < .05) related to self-blame (r s = 0.59), pessimism (r s = 0.59), and low optimism (r s = −0.56). Men’s appearance-related distress was significantly associated with low active coping (r s = 0.35), low use of emotional support (r s = 0.29), denial (r s = 0.39), behavioral disengagement (r s = 0.41), and pessimism (r s = 0.28). The only significant gender interaction reflected greater impact of optimism in reducing appearance-related distress for women (β = −0.06).Conclusions:This study showed that high levels of dispositional optimism decrease appearance-related distress, particularly for women. The coping strategies used differed between men and women, and the results suggest that both gender and psychosocial facto r s need to be considered in regard to appearance-related distress among individuals with UCLP in both clinical and research settings. A possible way to decrease distress is to strengthen positive coping strategies and dispositional optimism.
Highlights
Cleft lip and palate (CLP) is the most common congenital facial anomaly with a prevalence of approximately 1 in every 500 children born in Sweden (Hagberg et al, 1998)
This study showed that high levels of dispositional optimism decrease appearance-related distress, for women
The coping strategies used differed between men and women, and the results suggest that both gender and psychosocial facto rs need to be considered in regard to appearance-related distress among individuals with unilateral cleft lip and palate (UCLP) in both clinical and research settings
Summary
Cleft lip and palate (CLP) is the most common congenital facial anomaly with a prevalence of approximately 1 in every 500 children born in Sweden (Hagberg et al, 1998). Being born with CLP affects both the appearance of the face and the functions of the palate, such as speech and occlusion. Treatment consists of reconstructive surgeries, as well as orthodontics and speech therapy, aiming for good functional results (Marcusson et al, 2002). A cleft lip affects an individual’s facial appearance, and women with a cleft seem to be more dissatisfied with their. A qualitative study of adults born with cleft reported that women are more concerned than men about appearance (Stock et al, 2016a). The same phenomenon transpires; while both men and women experience poor body image, women are disproportionately more affected (Wang et al, 2019; Lacroix et al, 2020), which can be explained by cultural and societal norms (Strahan et al, 2006)
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