OBJECTIVE: To investigate the influence of gender, dispositional optimism, and coping strategies on appearance-related distress among individuals with unilateral cleft lip and palate (UCLP).

DESIGN: Cross-sectional design with self-report questionnaires analyzed primarily with Spearman correlations (r _s) and multivariate regression analyses.

SETTING: A tertiary cleft center in Sweden.

PARTICIPANTS: Eighty individuals with UCLP born 1966 to 1986. The mean age for men (n = 50) and women (n = 30) was 38.8 and 37.4 years, respectively.

MAIN OUTCOME MEASURES: The Derriford Appearance Scale 24 measured appearance-related distress, the Life Orientation Test-Revised, short version measured dispositional optimism and pessimism, and the Coping Orientation to Problems Experienced, short version included 14 coping strategies.

RESULTS: Women had higher appearance-related distress than men, which was significantly (P < .05) related to self-blame (r _s = 0.59), pessimism (r _s = 0.59), and low optimism (r _s = -0.56). Men's appearance-related distress was significantly associated with low active coping (r _s = 0.35), low use of emotional support (r _s = 0.29), denial (r _s = 0.39), behavioral disengagement (r _s = 0.41), and pessimism (r _s = 0.28). The only significant gender interaction reflected greater impact of optimism in reducing appearance-related distress for women (β = -0.06).

CONCLUSIONS: This study showed that high levels of dispositional optimism decrease appearance-related distress, particularly for women. The coping strategies used differed between men and women, and the results suggest that both gender and psychosocial facto r _s need to be considered in regard to appearance-related distress among individuals with UCLP in both clinical and research settings. A possible way to decrease distress is to strengthen positive coping strategies and dispositional optimism.