Objective: This review analyzes the psychological variables most frequently studied over the last 10 years in children and adolescents with cleft lip/palate (CL/P). Such variables are assumed to be the keys to these patients' psychosocial adjustment. Study design: Articles published from January 2007 to February 2017 were retrieved from PubMed to identify the psychological variables most commonly studied in children and adolescents with CL/P, irrespective of gender or type of cleft. The search terms were “cleft palate” and “psychology”, with the operator AND. Results: Of the 324 articles retrieved, 26 met the criteria for inclusion in the review. The psychological variables most extensively studied over the years were children's social functioning, quality of life and ability to cope. Conclusion: While CL/P patients' quality of life was unanimously agreed to be affected, no consensus was found in the literature on social functioning or coping. In addition to the cleft, patient adjustment was reported to be governed by individual variables and mediators. The range of ages most frequently studied was 7 to 16.
Objectives: 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.
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