Appraisal and coping in adults with cleft lip: associations with well-being and social anxiety.

The appraisal patterns and coping strategies of adults born with a cleft lip or cleft lip and palate were assessed in relation to measures of psychological well-being and social anxiety. A sample of 51 adults was recruited via the Cleft Lip and Palate Association. Data were collated using a questionnaire incorporating open questions and standardized measures. The focus was upon appraisal of the cleft, perceptions of consequences--both positive and negative--on personal and social dimensions, together with measurements of sense of coherence, psychological well-being, satisfaction with life and coping responses utilized in stressful situations. There was wide variability in the participants' reports of negative affect as a component of psychological well-being, suggesting that there may be small numbers of individuals with quite extreme responses. Seventy-five per cent reported difficulties which they attributed to their cleft. Perceiving positive gains as a result of the cleft and having a positive appraisal of facial appearance was associated with well-being. Patterns in coping strategies were also associated with emotional adjustment. Personal appraisals of both having a cleft and facial appearance may be more important in determining emotional well-being than the current medical emphasis on the aesthetics of surgical outcomes.