{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:57:30Z","timestamp":1790776650962,"version":"4.1.0"},"reference-count":45,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100006149","name":"Oxford University Hospitals NHS Foundation Trust","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100006149","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Some children born with a craniofacial condition, and their caregivers, can experience psychological difficulties. Psychological flexibility involves responding to internal distressing experiences (eg, emotions) with openness rather than avoidance, being present-focused, and behaving in ways that align with personal values. Psychological flexibility is typically associated with greater psychological well-being. The current study aimed to investigate whether psychological flexibility in caregivers of a child with a congenital craniofacial condition was associated with caregiver and child psychological well-being, to inform the development of interventions likely to help caregivers. It was hypothesized that higher levels of both general and parenting-specific psychological flexibility would be associated with greater psychological well-being in both caregivers and children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional questionnaire study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Questionnaires were completed online.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Caregivers (N\u2009=\u200989) of children aged 1-5 years with a congenital craniofacial condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure(s)<\/jats:title>\n                    <jats:p>Questionnaires measuring psychological flexibility, parenting-specific psychological flexibility, caregiver depression and anxiety, and caregiver-reported child well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Correlational and linear regression analyses revealed that higher parenting-specific psychological flexibility in caregivers was associated with\u2014and predictive of\u2014lower depression and anxiety in caregivers, and greater well-being in children. Higher general psychological flexibility in caregivers was associated with\u2014and predictive of\u2014reduced caregiver depression and anxiety and increased child well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early identification of caregivers of children with craniofacial conditions exhibiting difficulties with parenting-specific psychological flexibility, and the provision of psychological interventions to enhance psychological flexibility (acceptance and commitment therapy), is indicated for benefiting caregiver and child well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251392271","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:03:33Z","timestamp":1763402613000},"page":"2799-2807","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychological Flexibility in Caregivers of Children With Congenital Craniofacial Conditions in the United Kingdom"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0205-6596","authenticated-orcid":false,"given":"Laura","family":"Shepherd","sequence":"first","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2813-8015","authenticated-orcid":false,"given":"Fabio","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Aspland","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"White","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4400-0320","authenticated-orcid":false,"given":"Matthew","family":"Hotton","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1285-691X","authenticated-orcid":false,"given":"Nicola Marie","family":"Stock","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, University of the West of England, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1545273"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2016.1143944"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2016.1247838"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221125377"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2021.05.008"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221091699"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1044\/2024_PERSP-23-00236"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618768542"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656241236006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181ec6872"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jst049"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/17405629.2016.1154035"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.1994.tb00388.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202109_26791"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619862457"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619869146"},{"key":"e_1_3_3_18_2","volume-title":"Acceptance and Commitment Therapy: An experiential approach to behavior change","author":"Hayes SC","year":"1999","unstructured":"Hayes SC, Strosahl K, Wilson KG. 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