Impact of a Cleft Lip and/or Palate on Maternal Stress and Attachment Representations

Despars, Josée; Peter, C.; Borghini, Ayala; Pierrehumbert, Blaise; Habersaat, Stéphanie; Müller-Nix, Carole; Ansermet, François; Hohlfeld, Judith

doi:10.1597/08-190

Cited by 97 publications

(59 citation statements)

References 32 publications

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“…Our results support a family‐based treatment approach as opposed to only focusing on the affected child. Besides the direct effect on parents, parental (especially maternal) well‐being is an important predictor of a child's psychological outcomes (Despars et al ), and the mental health of parents can impact a child's health and educational achievement (Farahati et al ; Propper et al ; Frank & Ellen ). Incorporating psychosocial assessments of parents can be readily performed in settings that follow a team‐based approach to treating children with oral clefts with psychosocial expertise as part of the team.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial well‐being of parents of children with oral clefts

Nidey

Uribe

Marazita

et al. 2015

Child

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Background Parents of children with oral clefts may be impacted psychosocially in several ways, but empirical evidence remains relatively sparse. The aim of this study was to identify predictors of psychosocial wellbeing of parents of affected children. Methods The study included a total sample of 287 parents (171 mothers, 116 fathers) of children with oral clefts. Parents completed validated psychosocial instruments to measure social avoidance and distress, fear of negative evaluation scale, self-esteem and interpersonal support. Regression analysis was used to evaluate how selected child, parent, and household characteristics relate to psychosocial outcomes focusing on child’s cleft type, sex, and age, differences between mothers and fathers, marital status, and household income. Results Fathers had higher self-esteem than mothers (p=0.01) and lower concern of being negatively judged by others (p<0.0001) but also had lower perception of having someone to talk to about their problems (p=0.01). High household income was associated with greater self-esteem and perception of social support (<0.05). Parents of male affected children had greater perception of social support than parents of female affected children (p=0.04). No significant differences in parental psychosocial status measures were found by cleft type. Similarly, there is little evidence of changes with child age, except for an increase in parental distress and decline in self-esteem during mid adolescence (age 15–17 years). Conclusions The results indicate that mothers and fathers of children with oral clefts may differ in their psychosocial adjustment and that mothers may overall experience more psychosocial problems than fathers. Also, parents from less wealthy households may be at greater risk. Parental psychosocial status should be considered in holistic family-based treatment approaches to reduce burden on affected families and improve their wellbeing.

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Section: Discussionmentioning

confidence: 99%

Psychosocial well‐being of parents of children with oral clefts

Nidey

Uribe

Marazita

et al. 2015

Child

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“…In addition, these mothers smiled, made eye contact with, and touched their infants during breastfeeding to a lesser extent than did mothers of healthy infants (Goldberg, Morris, Simmons, Fowler, & Levison, ; Goldberg, Simmons, Newman, Campbell, & Fowler, ; Lobo, ). Similarly, secure attachment and the maternal attachment levels of mothers of infants with CP‐CL anomalies were found to be lower than those of mothers of healthy infants (Despars et al., ; Habersaat et al., ). According to these studies, trauma, depression, shock, and feelings of guilt arising from visible anomalies on the face cause mothers to be desensitized even toward normal developmental signs in their infants, and maternal emotional development is suppressed (Despars et al., ; Johansson & Ringsberg, ).…”

Section: Discussionmentioning

confidence: 96%

“…Similarly, secure attachment and the maternal attachment levels of mothers of infants with CP‐CL anomalies were found to be lower than those of mothers of healthy infants (Despars et al., ; Habersaat et al., ). According to these studies, trauma, depression, shock, and feelings of guilt arising from visible anomalies on the face cause mothers to be desensitized even toward normal developmental signs in their infants, and maternal emotional development is suppressed (Despars et al., ; Johansson & Ringsberg, ). Additionally, an infant with a facial defect gives less expressive facial responses compared with his or her healthy peers, which negatively affects the mother–infant interactions (Habersaat et al., ).…”

Section: Discussionmentioning

confidence: 96%

Does the visibility of a congenital anomaly affect maternal–infant attachment levels?

Boztepe

Yıldız

et al. 2016

Specialist Pediatric Nursing

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“…These last results are close to our own findings. Such emotional aloofness has been highlighted in the literature (Despars et al., ; Johannson & Ringsberg, 2004), and it may be associated with parental difficulties when confronting such an adverse perinatal event. Further research should be undertaken in this field to complete these observations and to understand the nature and evolution of the complexities of this relationship.…”

Section: Discussionmentioning

confidence: 99%

Attachment in Infants With Cleft Lip and/or Palate: Marginal Security and Its Changes Over Time

Borghini¹,

Despars²,

Habersaat³

et al. 2018

Infant Mental Health Journal

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This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent-infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old-which can be considered marginally secure at that age-may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.

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Impact of a Cleft Lip and/or Palate on Maternal Stress and Attachment Representations

Abstract: Mothers of children with a cleft may benefit from supportive therapy regarding parent-child attachment, even when they express low posttraumatic stress disorder symptoms.

Cited by 97 publications

References 32 publications

Psychosocial well‐being of parents of children with oral clefts

Psychosocial well‐being of parents of children with oral clefts

Does the visibility of a congenital anomaly affect maternal–infant attachment levels?

Attachment in Infants With Cleft Lip and/or Palate: Marginal Security and Its Changes Over Time

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