Psychosocial adjustment in adolescents with craniofacial anomalies: a comparison of parent and self-reports.

OBJECTIVE To assess rates of psychosocial adjustment problems in adolescents with craniofacial anomalies (CFAs) and to evaluate the correspondence between adolescent and parent reports of adjustment. DESIGN Retrospective chart review. SETTING Reconstructive plastic surgery department in urban medical center. PARTICIPANTS Sixty-four adolescents aged 14 to 18 years with CFAs and their parents. MAIN OUTCOME MEASURES Child Behavior Checklist, Youth Self-Report. RESULTS Adolescent and parent reports were compared with published norms. Adolescents with CFAs did not differ from norms on rates of self-reported problems in the clinical range. Parents of sons and daughters with CFAs reported elevations in the clinical range for deficits in social and scholastic competence; parents of daughters also reported higher clinical rates of withdrawn and somatic problems. Correlations between adolescent and parent reports were generally higher than seen in norms, especially for boys. Parents and adolescents did not differ in reported rates of problems in the clinical range. CONCLUSIONS Adolescents with CFAs showed elevated risk for problems with academics and peer relationships; there was limited evidence for clinical levels of other adjustment problems. When parent and adolescent reports differed, parents reported more problems.