Understandings of Psychosocial Issues associated with Facial Disfiguerment—A Review of The Literature—

Abstract

This article presents 1) a critical review of literature on psychoooccal impact of facial disfigurement and 2) recommendations for future research. A search of the literature was performed on Ovid MEDLINE and Web of Science using“facial disfigurement”as a key word. Reference lists were screened for studies that presented scientific evidence. Based on a biological-psychological-social model, findings were classified into physical, psychological and social areas. In the physical area, there has been found a conceptual shift towards the study of facial disfigurement as a phenomenon independent of etiology. Age of disfigurement onset, length of time after the onset and severity of the disease does not always predict the psychological impact. Further examination of the impact in each developmental stage is needed. In the psychological area, most of the studies support deterioration of psychological well being among people with facial disfigurement. Therefore, interventions and assistance are required to promote psychological health. In the social area, facially disfigured people are exposed to a variety of stigmatizing situations, which is associated with deterioration of psychological health. However, studies to date lack understandings of patient-doctor relationships and practical suggestion to ameliorate stigmatization. As a non-adaptive coping strategy, avoidance and concealment has been attracted growing academic attention. Although high level of social support often predicts positive psychological adaptation, its structure of association remains to be revealed in detail. Future research particularly needs to address familial relationships and support from a life cycle perspective.