The effects of society on the psychosocial functioning of those with a facial difference

Abstract

Adolescents with craniofacial conditions (CFCs) may experience intrapersonal and interpersonal challenges such as a greater sensitivity to attractiveness, fewer social supports, and more social withdrawal, all of which can hinder social interactions. However, there are contradictory findings as to whether adolescents with CFCs have more social problems than their peers. This article provides a framework for the social context of interpersonal relationships for those with CFCs drawn from relevant theoretical underpinnings. The authors conducted a comprehensive literature review examining social factors that affect the interpersonal functioning of adolescents with CFCs. Over 35 articles were taken from the growing, but limited, research on this topic via PsychInfo and PubMed using specific search terms such as "craniofacial", "facial dysmorphisms", "complex facial dysmorphisms", "interpersonal", "psychosocial", "social functioning", and "adolescents" among others. Research has identified three salient barriers in social interactions: unattractive or inexpressive faces, social stigma, and societal misconceptions. The empirical studies reviewed postulate that having a facial difference does not result in social dysfunction, but rather the pressures and influences of society negatively impact social functioning. Based on the findings from this review, the authors propose a novel psychosocial model that explains the social dysfunction of adolescents with CFCs. Limitations and future interventions are also discussed.