Predictors of mental health and quality of life in adults with craniofacial conditions

Abstract

Adults with craniofacial conditions reportedly experience higher levels of psychosocial problems than the general population. However, our understanding of the factors that contribute to the mental health and quality of life in these adults is poor due to the limited availability of research. This study examined some of the predictors of positive outcomes in adults who have grown up with a variety of craniofacial conditions. Adults (n= 95, mean age 29 years) with congenital craniofacial conditions, who were treated as children in the Australian Craniofacial Unit, completed measures of: mental health (Hospital Anxiety and Depression Scale), quality of life (SF-36), social support (Multidimensional Scale of Perceived Social Support), self esteem (Rosenberg Self-Esteem Scale), satisfaction with appearance, fear of negative evaluation (Brief Fear of Negative Evaluation Scale) and appearance concerns (Derriford Appearance Scale). Multiple regression analyses revealed that the strongest predictors of anxiety were self esteem, appearance concerns and fear of negative evaluation, while depression was predicted by self esteem and social support. Age, gender and satisfaction with facial appearance did not contribute to either anxiety or depression. The Physical Health Component of the quality of life measure was predicted by satisfaction with facial appearance and appearance concerns, while the Mental Health Component was predicted by social support, self esteem and appearance concerns. Again, gender and age did not contribute to either outcome. These results highlight the importance of self esteem, social support and concerns about appearance to a range of mental health outcomes in these adults, with fear of negative evaluation specifically predictive of anxiety. Of note, satisfaction with facial appearance was unrelated to mental health outcomes, and gender and age were unrelated to all outcomes. These findings underline the importance of thoroughly assessing adults with craniofacial conditions and not simply focusing on satisfaction with appearance. They also provide some possible targets for childhood interventions designed to build resilience in this population.