Adjustment in adolescents with cleft lip and palate: A preliminary investigation into experiences of shame and bullying

For some young people, the experience of having a facial disfigurement such as a cleft lip and palate can result in negative social interactions, often originating from the stereotyping reaction of others. Using the social rank theory of shame, the effects of bullying and teasing were investigated in a patient group of 16, 12-18 year olds with cleft lip or cleft lip and palate. The patient group were compared with a group of 16 of their peers with regards to their experiences of bullying and teasing, shame-proneness and the focus of their shame. The interactional effects of shame and bullying were also investigated in order to test a shaming-loop model of negative social interaction. The investigation necessitated two separate studies. The first study involved 215 adolescents from a secondary school and was required for the development of a focus of shame scale and the gathering of data for establishing its psychometric properties. It also enabled data to be collected regarding the experiences of shame and bullying in adolescents without cleft lip and palate, in order that a random sample of 16 school adolescents matched with the patient sample on age and gender, may act as a comparison group. Participants completed self-report questionnaires concerning shame-proneness and focus of shame, and a semi-structured interview regarding their experiences of bullying. The second study involved the administration of the same measures to the patient sample. Results showed high levels of bullying for both groups although there was no overall difference between the groups. Differences were seen in focus of shame scores, with the patient group having higher scores on shame related to facial appearance than their comparisons. No overall differences were seen on scores of shame-proneness. The implications of the findings are discussed and limitations of the study acknowledged.