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      A longitudinal evaluation of psychosocial changes throughout orthognathic surgery

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Jaw correction surgery can cause significant psychosocial impacts on patients. This prospective study investigated the longitudinal changes of psychosocial characteristics of patients with dentofacial deformities after jaw correction surgery and the factors that predict the psychological resilience in Hong Kong Chinese undergoing jaw correction surgery.

          Methods

          A longitudinal cohort study was conducted on 92 Hong Kong Chinese patients (32 males, 60 females; mean age = 24.75 ± 5.65 years), who had jaw correction surgery as treatment for their dentofacial deformities, from 1 st June 2011 to 30 th June 2015. Self-completed psychological inventories including Brief Symptom Inventory, Life Orientation Test, and the Adult Trait Hope Scale were used to measure distress, optimism, and hope levels respectively. Patients completed the inventories in five time points: the surgical consent signing day (usually two to three months before the surgery) (T1); one day before operation (T2), first to second post-operative week (T3), third post-operative month (T4) and sixth post-operative month (T5).

          Results

          Latent class growth analysis revealed two outcome trajectory classes: a resilience trajectory (n = 45, 48.9%) and a chronic dysfunction trajectory (n = 14, 15.2%). Another 33 (35.9%) showed erratic trajectory patterns that would not be classified into any categories. The psychological distress levels of patients in the resilience trajectory group, on average, were below the clinical threshold of the Brief Symptom Inventory at all time points. However, the opposite result was obtained for patients in the chronic dysfunctional group. Patients exhibiting a resilience trajectory pattern, when compared to those showing a chronic dysfunction pattern, had higher optimism (t(57) = 3.69, p < .0001) and hope (t(57) = 2.46, p < .05) levels at T1. Logistic regression analyses were conducted to compare the relative power of optimism and hope levels at T1 to predict resilience or chronic dysfunctional group membership. A test of the full model against a constant only model was statistically significant (χ 2(2) = 24.096, p < .01). Preoperative baseline optimism (B = —.276, p < .05) but not hope (B = —.25, ns) was a significant variable to classify the outcome trajectories for psychological distress.

          Conclusions

          Most patients were resilient to dentofacial deformities jaw correction surgery. About 15% exhibited a chronic distress pattern. An optimistic view about the surgery may enhance resilience. Pre-surgical counselling or educational sessions to facilitate a realistic positive outlook about the operation would be beneficial.

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          Most cited references 16

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          Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test.

          Research on dispositional optimism as assessed by the Life Orientation Test (Scheier & Carver, 1985) has been challenged on the grounds that effects attributed to optimism are indistinguishable from those of unmeasured third variables, most notably, neuroticism. Data from 4,309 subjects show that associations between optimism and both depression and aspects of coping remain significant even when the effects of neuroticism, as well as the effects of trait anxiety, self-mastery, and self-esteem, are statistically controlled. Thus, the Life Orientation Test does appear to possess adequate predictive and discriminant validity. Examination of the scale on somewhat different grounds, however, does suggest that future applications can benefit from its revision. Thus, we also describe a minor modification to the Life Orientation Test, along with data bearing on the revised scale's psychometric properties.
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            Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss.

            The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-months postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.
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              Prospective patterns of resilience and maladjustment during widowhood.

              Using prospective longitudinal data on an older sample beginning prior to the death of a spouse, G. A. Bonanno et al. (2002) distinguished 5 unique trajectories of bereavement outcome: common grief, chronic grief, chronic depression, depression followed by improvement, and resilience. These trajectories having been identified, the aims of the current study were to examine differences in how respondents in each group reacted to and processed the loss. Specific hypotheses were tested regarding differences in coping, meaning making, context, and representations of the lost relationship. Results suggest that chronic grief stems from the upheaval surrounding the loss of a healthy spouse, whereas chronic depression results from more enduring emotional difficulties that are exacerbated by the loss. Both the resilient and the depressed-improved groups showed remarkably healthy profiles and relatively little evidence of either struggling with or denying/avoiding the loss. ((c) 2004 APA, all rights reserved)
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draft
                Role: Data curationRole: Formal analysis
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 September 2018
                2018
                : 13
                : 9
                Affiliations
                [1 ] Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
                [2 ] Psychology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
                Universidade Federal Fluminense, BRAZIL
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Article
                PONE-D-18-11176
                10.1371/journal.pone.0203883
                6135509
                30208105
                © 2018 Suen et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 2, Tables: 5, Pages: 12
                Product
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biology and Life Sciences
                Anatomy
                Head
                Jaw
                Medicine and Health Sciences
                Anatomy
                Head
                Jaw
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Dental and Oral Procedures
                Orthognathic Jaw Surgery
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Dental and Oral Procedures
                Biology and Life Sciences
                Anatomy
                Head
                Face
                Medicine and Health Sciences
                Anatomy
                Head
                Face
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Medicine and Health Sciences
                Health Care
                Psychological and Psychosocial Issues
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Medical Doctors
                Surgeons
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                Medical Doctors
                Surgeons
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Medical Doctors
                Physicians
                Surgeons
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                Medical Doctors
                Physicians
                Surgeons
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized

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