Adolescents with Craniofacial Anomalies: Psychosocial Adjustment as a Function of Self-Concept

Abstract

Objective To evaluate associations between self-concept and psychosocial adjustment among adolescents with craniofacial anomalies. Design Retrospective chart review. Setting Reconstructive plastic surgery department in urban medical center. Participants Forty-nine adolescents with congenital craniofacial anomalies, aged 14 to 18 years, and their parents. Main Outcome Measures Psychosocial adjustment (internalizing problems and social competence), assessed by self-report and parent-report forms of the Child Behavior Checklist; appearance self-concept and global self-worth, assessed by the Self-Perception Profile for Adolescents. Results Both appearance self-concept and global self-worth were associated with psychosocial adjustment; however, global self-worth remained associated with adjustment when the effects of appearance self-concept were controlled, whereas appearance self-concept was no longer associated with adjustment when global self-worth was controlled. Demographic variables (ethnicity, socioeconomic status, and adolescent gender) largely failed to moderate the associations between self-concept and adjustment. Conclusions Adolescent dissatisfaction with appearance is linked to psychosocial adjustment problems only when it is part of a negative overall view of the self.