Psychological aspects of orthognathic surgery

Abstract

With the dramatic growth in the number of adults undergoing orthodontics to correct malocclusion, and those undergoing surgical orthodontics or orthognathic surgery to correct skeletal discrepancies in the orofacial region, it is important to examine the psychological characteristics of these patients before and after treatment is completed. This paper serves as a general review and summarizes the findings of two major longitudinal studies of patients seeking surgical correction and compares them with people who underwent conventional orthodontics, those who rejected any treatment, and those who sought cosmetic surgery. Both studies revealed that most women seeking surgical orthodontics focused on aesthetic improvement as a motive, whereas men sought to improve their appearance and mastication. Women were also more likely to report problems with the temporomandibular joint as a motive. Men and women scored similarly on a measure of body image, although women reported lower facial image presurgically and higher postsurgically than did men. The greatest gains following surgery were in facial and profile image for both men and women. Orthodontic patients showed less improvement, while those rejecting treatment experienced a decline in body image. Many functional improvements did not occur until 24 months postoperatively; lingering paraesthesia was described by 49% of the sample. Emotional reactions included anxiety preoperatively, and depression postoperatively, especially among patients scoring high on neuroticism and those experiencing other major life events. These studies reveal that people seeking surgical orthodontics are within the normal range of most personality measures and experience greater gains psychologically than do conventional orthodontic patients.     

Self-Reported Psychological Well-Being and Disease-Related Strains among Adults with Diabetes

The study was designed to describe self-reported psychological well-being among adults with Type 1 and Type 2 diabetes and to explore associations of psychological well-being with disease-related strains, such as self-reported long-term complications, frequency of hypoglycaemia and disablement or sick-leave. A sample comprising 534 Norwegian adults with Type 1 and Type 2 diabetes aged 25-70 years participated in the study. Psychological well-being was assessed using three different scales; the WHO (Ten) Well-Being Index, the Short Zung Depression Rating Scale and four items from the anxiety sub-scale of the Hopkins Symptom Checklist. Findings indicate that adults with both types of diabetes reported relatively poor psychological well-being. There was a tendency for younger persons to report the worst psychological well-being. For symptoms of anxiety this tendency was most evident among people with Type 2 diabetes. People being disabled due to diabetes reported relatively markedly impaired psychological well-being, whereas self-reported diabetes-related complications and the number of episodes with hypoglycaemia were weakly associated with psychological well-being. Findings may indicate that healthcare practitioners should pay more attention to the psychological needs of people with diabetes. This applies especially to younger people with Type 2 diabetes.     

Psychological wellbeing and the diathesis-stress hypothesis model: The role of psychological functioning and quality of relations in promoting subjective well-being in a life events study

Negative life events are associated with poor wellbeing and mental health outcomes. Following a diathesis-stress model, we tested whether psychological functioning and quality of interpersonal relationships moderated the effect of life events on subjective wellbeing. This study comprised data from a young and middle-aged adult sample (n = 364) drawn from an Australian university-student population. Results indicated that life events were associated with negative but not positive wellbeing outcomes. Perceived impact of life events was a stronger predictor of wellbeing than was the number of life events. Psychological functioning and quality of interpersonal relationships were associated with both wellbeing dimensions but only quality of interpersonal relationships moderated the effect of life events on wellbeing. In conclusion, perceived impact of life events was more strongly related to wellbeing than number of life events. Interpersonal relationships moderate the effect of life events with those reporting higher levels of quality of interpersonal relationships reporting less decrement in negative affect following stressful life events.     

Closure of autobiographical memories: The effects of written recounting from first- or third-person visual perspective

Autobiographical memories are recalled with varying degrees of psychological closure. Closure is a subjective assessment of how far a remembered experience feels resolved, and it has been suggested that one predictor of closure is the amount of emotional detail in the memory. Study 1 examined which aspect of emotional detail is important for closure, and showed that open and closed negative memories were distinguished by ratings of emotion evoked during recall, not by remembered emotion from the time of the event. The recall of open memories was accompanied by more intense, more negative, and less positive emotion than the recall of closed memories. Biased retelling of memories has been shown to influence closure and on the basis of evidence that third-person recall serves a distancing function, Study 2 examined whether instructions to repeatedly recount an open memory from a third-person perspective would increase closure compared with a single or repeated recounting from a first-person perspective. While repeated third-person recounting had the greatest influence on closure, there were also increases in the first-person recounting groups. The results suggest that closure can be increased by reporting memories in written narrative form, particularly if repeatedly expressed from the third-person perspective.     

La gestion de la souffrance par le psychologue clinicien. Étude des impacts et des stratégies de coping

We focus in this study on strategies used by clinical psychologists to cope with their own or patient psychological distress in the framework of help relationship. A self-administered form was sent to listings of professionals by e-mail. The sample is made of 187 French clinical psychologists. To cope with patients’ suffering, psychologists use mostly avoidance coping style. And the strategies they prefer are “supervision”, “personal therapy” and “speaking with colleagues” (problem focused coping strategies). To cope with their own distress, which has a lot of negative impacts on help relationship, psychologists have most frequently a problem focused coping style but their favourite strategy is to “lighten their schedules”. And almost a quarter of the sample presents a significant level of distress. In conclusion, results show that psychological distress management by psychologists is an important question with a lot of ethical questions.     

Conflict escalation and coping with workplace bullying: A replication and extension

Bullying or mobbing is used for systematically harassing a person for a long time. In the context of stress theory, bullying is a severe form of social stressors at work, whereas in terms of conflict theory, bullying signifies an unsolved social conflict having reached a high level of escalation and an increased imbalance of power. Based on a qualitative study with 20 semi-structured interviews with victims of bullying and a quantitative questionnaire study with a total of 149 victims of bullying and a control group (N = 81), it was investigated whether bullying victims use specific conflict management strategies more often compared with individuals who are not bullied, and whether coping strategies used by successful copers with bullying differ from those of the unsuccessful copers. Successful copers were those victims who believe that their situation at work has improved again as a result of their coping efforts. The qualitative data showed that most victims started with constructive conflict-solving strategies, changed their strategies several times, and finally tried to leave the organization. In the interviews, the victims of bullying most often recommended others in the same situation to leave the organization and to seek social support. They more often showed conflict avoidance in the quantitative study. Successful victims fought back with similar means less often, and less often used negative behaviour such as frequent absenteeism. Moreover, they obviously were better at recognizing and avoiding escalating behaviour, whereas in their fight for justice, the unsuccessful victims often contributed to the escalation of the bullying conflict.     

Switching on and off … : Does smartphone use obstruct the possibility to engage in recovery activities?

This study examines the impact of work-related smartphone use on daily recovery from work-related efforts. The literature shows that work–home interference (WHI) is an important inhibitor of the recovery process. We propose that the extensive use of smartphones with its implicit request of 24/7 availability inhibits the process of engaging in activities that are required for daily recovery. A total of 80 employees (40 smartphone users, 40 controls) completed a 6-day diary questionnaire over a time period of 2 weeks. Contrary to our hypothesis, smartphone users did not experience more overall WHI than nonusers. Furthermore, four activities aimed at recovery were examined. We predicted that daily WHI would increase employees’ engagement in recovery activities, but only if they did not use a smartphone. Results showed that, for the control group, WHI was positively related to psychological detachment, relaxation, mastery, and control activities, whereas smartphone users facing high WHI did not succeed in engaging in these recovery activities. This implies that being connected to work in the evening hours through smartphones has consequences for the extent to which employees succeed in undertaking recovery activities.     

Value incongruence,job autonomy,and organization-based self-esteem: A self-based perspective on organizational cynicism

Combining the perspectives of person-environment fit and self-theory, a model was postulated in which both the incongruence between personal and perceived organizational values and job autonomy precede organizational cynicism, while organization-based self-esteem, as a psychological explanation for cynicism, was hypothesized to mediate both relationships. The model and corresponding hypotheses were tested on a sample of 174 Dutch workers. Polynomial regression results indicated that value incongruence and job autonomy add significantly to the prediction of organizational cynicism. Hierarchical regression analysis was used to test the hypothesized mediating effect of organization-based self-esteem. Results indicated that self-esteem partially mediates both relationships. These results support the conceptualization of organizational cynicism as a self-defensive response to problematic events and circumstances in the work environment.     

Redesigning work through idiosyncratic deals

This study links idiosyncratic deals (i-deals) to job design theory. It investigates the impact of individually negotiated job changes on performance, self-efficacy, and psychological strain through their intervening effects on work design. Based on a sample of 187 health care professionals employed by a hospital in Germany, three types of work design-related i-deals were investigated: (1) task, (2) career, and (3) flexibility i-deals. Consistent with hypotheses, the three types of i-deal had differential effects on work characteristics, and each in turn related to different outcomes. Specifically, job autonomy mediated the task i-deals—job performance relationship; skill acquisition mediated the career i-deals—occupational self-efficacy relationship; and reduced work overload mediated the flexibility i-deals—emotional and affective irritation relationships. Leader–Member Exchange was confirmed as an antecedent of all three types of i-deals. Task, career, and flexibility i-deals are discussed as ways to make work more intrinsically motivating, ensure one’s professional advancement, and balance workplace stressors.