Study examines psychosocial impact of cleft lip, palate on individuals in non-Anglo societies

One person's flaw may be another person's strength, according to a study of cultural perceptions of cleft lip and cleft palate. In the Western world, many people with these facial anomalies experience social and emotional difficulties because of the importance placed on appearance. In other parts of the world, a range of views are influenced by religion, superstition, and cultural prejudices.

The article in the September 2011 issue of Cleft Palate-Craniofacial Journal, examines the psychosocial impact of having a cleft lip, cleft palate, or both, on individuals in non-Anglo societies. Researchers present a meta-analysis of studies conducted in China, Hong Kong, Taiwan, and Norway that included a total of 2,276 adolescents and adults with cleft lip and/or palate (CL/P).

Past studies have described a variety of reactions to CL/P. In India, those of the Hindu religion have seen the anomaly as a source of shame due to sins of a past life. For Indian girls, it can be considered an obstacle to finding a husband, and an unmarried woman can be a burden to her family. China, the Philippines, and other developing countries reportedly view any facial disfigurement as a curse, ostracizing those who are affected.

In a more positive light, the Chamorro culture of the Mariana Islands sees a person with CL/P as "a gift from God, who belongs to everyone" and is to be protected and sheltered. The facial anomaly is a source of pride to some Amazon cultures. And in a Brazilian shantytown, those with CL/P are seen as survivors, having "avenged fate."

The results of the current study show that, among those in non-Anglo cultures with CL/P, men are more likely than women to have psychosocial issues, and adults are more affected than adolescents. Among the four countries studied, people with CL/P in Shanghai, China, were most negatively affected, while those in Hong Kong appeared to be least affected.

Individuals with CL/P, no matter what their culture, gender, or age, are found to have lower psychological and emotional adjustment than those without CL/P. Those who provide health care and psychological intervention for people with CL/P can benefit from this examination of cultural attitudes. In countries such as the United States, where a conglomerate of cultures and beliefs come together, providers will be better able to communicate with and effectively treat patients with this anomaly.