Facial palsy (FP) affects an estimated 100,000 people in the United Kingdom (Facial Palsy UK, 2012). It is characterised by facial muscle weakness resulting from damage to the facial nerve and is associated with congenital conditions, such as Moebius syndrome, and acquired conditions, such as Bell's palsy, Ramsay Hunt syndrome, trauma affecting the facial nerve, and acoustic neuroma. FP can cause a range of issues including: corneal exposure leading to blindness; visual disturbance; problems with facial function, leading to difficulties with facial expression, eating, drinking, hearing and/or speaking (Shindo, 1999).Current treatment options include: injections of Botulinum Toxin A (Filipo, Spahiu, Covelli, Nicastri, & Bertoli, 2012); static and dynamic surgical procedures (Ghali, MacQuillan, & Grobbelaar, 2011) and facial therapy focusing on rehabilitating function and appearance (van Landingham, Diels, & Lucarelli, 2018). Options to protect the ocular surface include eyelid repositioning surgery, eyelid loading with weights and tear duct surgery (Schrom, Buchal, Ganswindt, & Knipping, 2009). Changes in facial function and appearance due to FP, as well as uncertainty about recovery, can result in anxiety, social isolation and concealment of facial appearance, with individuals with FP also reporting low self-esteem, high levels of self-consciousness and concerns about mood (Norris et al., 2019). These psychosocial difficulties may reflect the impact of FP on the use of the face to express emotions, a skill which is crucial for communication (Coulson, O'Dwyer, Adams, & Croxson, 2004). The visible difference associated with FP is often made more apparent by difficulties in facial movement with many affected avoiding facial expression of emotion (Bradbury, Simons, & Sanders, 2006). Others can interpret this absence of expression negatively, leading to greater avoidance of social interactions by individuals with FP. These parallel issues lead to a combined challenge of being unable to express oneself and stigma for having a visible facial difference (Bogart, Tickle-Degnen, & Joffe, 2012). ObjectivesNo paper has systematically reviewed the literature investigating the psychosocial impact of FP. Instead, previous reviews have focused on observer perceptions (Nellis, Ishii, Boahene, & Byrne, 2018) and the quality of patient-reported outcome measures (Ho et al., 2012). This review aims to provide a deeper understanding of FP by 1) systematically reviewing the impact of FP on levels of psychological distress, social function and quality of life (QoL) and 2) determining the demographic factors (e.g. age, duration of FP, aetiology, gender etc.) associated with poorer psychosocial outcomes. Methods Protocol and registrationInclusion criteria and methods for study selection were specified in advance and documented in a BLINDED-registered protocol (DETAILS BLINDED FOR SUBMISSION).. Information sourcesStudies were identified by searching electronic databases and by scanning the reference lists of included studies. Literature ...

The process of worry has been associated with reductions in working memory capacity and availability of resources necessary for efficient attentional control. This, in turn, can lead to escalating worry. Recent investigations into working memory training have shown improvements in attentional control and cognitive performance in high trait-anxious individuals and individuals with sub-clinical depression. The current randomised controlled trial investigated the effects of 15 days of adaptive n-back working memory training, or an active control task, on working memory capacity, attentional control and worry in a sample of high worriers. Pre-training, post-training and one-month follow-up measures of working memory capacity were assessed using a Change Detection task, while a Flanker task was used to assess attentional control. A breathing focus task was used as a behavioural measure of worry in addition to a number of self-report assessments of worry and anxiety. Overall there was no difference between the active training and the active control condition with both groups demonstrating similar improvements in working memory capacity and worry, post-training and at follow-up. However, training-related improvements on the n-back task were associated with gains in working memory capacity and reductions in worry symptoms in the active training condition. These results highlight the need for further research investigating the role of individual differences in working memory training.

A u t i s m s p e c t r u m d i s o r d e r ( A S D ) i s characterised by social difficulties that can have a negative impact on an individual's psychological and social wellbeing. To date, reviews of social skills training groups have mainly focussed on children, rather than adolescents and adults. This review aimed to critically evaluate studies published in the past 20 years that had used group-based social skills training to improve the social skills of adults and/or adolescents with ASD. Thirteen studies were identified, and group-based social skills training was generally effective at improving social skills, with some studies observing transfer effects to improvements in wider psychological wellbeing. Future research should focus on comparing different social skills training protocols in real-world clinical settings.

No abstract

Objective: To determine the psychosocial adjustment of children born with a cleft lip and/or palate (CL/P). Design: Longitudinal analyses of psychosocial outcomes and cross-sectional comparison with published norms. Setting: Retrospective clinical audit at a UK cleft center. Participants: Data available for 1174 participants born with a CL/P at ages 5 (n = 658), 10 (n = 415), and 15 (n = 171), with longitudinal data for a subset of the sample at 5 and 10 (n = 168) and 10 and 15 (n = 49). Main Outcome Measure: Parental-report Strengths and Difficulties Questionnaire (SDQ). Results: The majority of children scored in the average range for overall adjustment. Children born with CL/P had significantly higher mean overall SDQ scores relative to normative data at ages 5 and 10. Longitudinal analysis highlighted that adjustment at age 5 was a significant predictor of adjustment at age 10. Gender was another significant predictor of adjustment at age 5 and 10, with boys reporting more problems than girls. However, effect sizes for the impact of age and gender were small. Cleft type was not a significant predictor of SDQ score at any age. Conclusions: Children aged 5 and 10 years of age born with a cleft may experience greater overall psychosocial difficulties than the general population. The domains on the SDQ on which children experience difficulty may be influenced by age and gender. Future research should focus on the specific impact of cleft-related issues, including speech, language, and hearing difficulties, on psychosocial adjustment.

Objectives Previous literature finds that having a child with a cleft lip and/or palate (CL/P) may pose social and emotional challenges for parents. For parents of children born during the Covid-19 pandemic, such challenges may be heightened. Further, novel demands brought about by the pandemic could have caused additional hardships. The aim of this study was to describe the impact of the pandemic on new parents through qualitative exploration of their experiences. Design Semi-structured interviews were conducted with 14 parents of children born in the United Kingdom with CL/P between January and June 2020, around the start of the pandemic. Data were analysed using inductive thematic analysis. Results Three themes, with sub-themes, were identified. The first theme, “ Changes to Healthcare: The Impact of Restrictions and Reduced Contact”, discussed the impact of the pandemic on perinatal care, the care received from the specialist CL/P teams, and parents’ experiences of virtual consultations. The second theme, “Family Functioning During the Pandemic”, covered parental anxiety, fathers’ experiences, and social support. The third theme, “ Surgical Prioritisation: Delays and Uncertainty”, addressed changes to surgical protocols, coping with uncertainty, complications associated with delayed surgery, and how parents created positive meaning from this period. Conclusions A range of increased and additional psychosocial impacts for parents were identified, along with several coping strategies, utilization of social support, and the positive aspects of their experiences. As the pandemic continues, close monitoring of families affected by CL/P remains imperative, particularly for those at risk of emotional distress.

No abstract

Introduction: Facial palsy is often associated with impaired facial function and altered appearance. However, the literature with regards to the psychological adjustment of children and adolescents with facial palsy has not been systematically reviewed to date. This paper aimed to review all published research with regards to psychosocial adjustment for children and adolescents with facial palsy. Methods: MEDLINE, CINAHL, Embase, PsychInfo and AMED databases were searched and data was extracted with regards to participant characteristics, study methodology, outcome measures used, psychosocial adjustment and study quality. Results: Five studies were eligible for inclusion, all of which investigated psychosocial adjustment in participants with Moebius syndrome, a form of congenital facial palsy. Many parents reported their children to have greater social difficulties than general population norms, with difficulties potentially increasing with age. Other areas of psychosocial adjustment, including behaviour, anxiety and depression, were found to be more comparable to the general population. Discussion: Children and adolescents with Moebius syndrome may experience social difficulties. However, they also demonstrate areas of resilience. Further research including individuals with facial palsy of other aetiologies is required in order to determine the psychosocial adjustment of children and adolescents with facial palsy.