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.     

Remember me? Psychopathic traits and emotional memory in an undergraduate sample

We investigated the effects of psychopathy on emotional memory among a predominantly female undergraduate sample. Undergraduates (N = 153, mean age = 20.1; 80.1% female; 57.1% Caucasian) completed a facial memory task. Participants were presented with a series of faces (sad, scared, angry, happy, neutral), completed a self-report measure of psychopathy, and were presented with another series of faces (with some from the first phase, and some new). Participants were asked whether they recognized each face from the first set, and reaction time (RT) was measured. Although memory for emotional faces did not differ from neutral faces, there were main effects of emotion, gender and psychopathy on RT. A significant 3-way interaction revealed that males who were higher in psychopathy had slower RTs; they were slow to remember sad, angry and neutral faces. In conclusion, psychopathy may affect emotional memory differently across gender. Specifically, undergraduate men, but not women, with higher psychopathy levels may show impaired memory for emotional faces. Implications for future studies of emotional memory and psychopathy are discussed.     

Psychopathy and verbal emotion processing in non-incarcerated males

Incarcerated males who score high on personality measures of psychopathy are reported to be less efficient than other incarcerated males in processing emotionally laden stimuli. In this study, we evaluated whether an emotion deficit is also present in non-incarcerated higher functioning males who score high on psychopathy personality measures. A sample of male university students was screened for psychopathic personality, and two subsamples, those who scored high or low on global psychopathy, participated in a series of language processing tasks designed to assess verbal emotion processing. Unlike previous studies of emotion processing in the verbal domain, stimuli also systematically varied in abstractness. The results showed that participants scoring high in psychopathy were less efficient than those scoring low in psychopathy in processing negatively valenced words, across all levels of word abstractness. The results extend previous accounts of emotional processing deficits in individuals with psychopathic personality to a relatively high-functioning non-incarcerated sample.     

Facial expression discrimination varies with presentation time but not with fixation on features: A backward masking study using eye-tracking

The current study investigated the effects of presentation time and fixation to expression-specific diagnostic features on emotion discrimination performance, in a backward masking task. While no differences were found when stimuli were presented for 16.67 ms, differences between facial emotions emerged beyond the happy-superiority effect at presentation times as early as 50 ms. Happy expressions were best discriminated, followed by neutral and disgusted, then surprised, and finally fearful expressions presented for 50 and 100 ms. While performance was not improved by the use of expression-specific diagnostic facial features, performance increased with presentation time for all emotions. Results support the idea of an integration of facial features (holistic processing) varying as a function of emotion and presentation time.     

Embodied simulation as part of affective evaluation processes: Task dependence of valence concordant EMG activity

The current studies investigated age-related biases in recall of emotion in older and younger adults. In two prospective–retrospective, Internet-based diary studies, older (aged 65 years and older) and younger participants (aged 18 to 37) reported on their affect at the end of every day. Participants then recalled their affect during the diary rating periods. In both studies, recall bias was assessed by comparing retrospective reports to the prospective diary ratings. Older adults tended to overestimate positive affect more than younger adults, who themselves tended to overestimate negative affect more than older adults, relative to diary ratings. Age-related patterns of recall bias are discussed in light of recent literature on the interface between cognition and emotion in ageing, particularly on increased positivity and reduced negativity effects in emotional processing and recall.     

Nonverbal signals speak up: Association between perceptual nonverbal dominance and emotional intelligence

Emotional communication uses verbal and nonverbal means. In case of conflicting signals, nonverbal information is assumed to have a stronger impact. It is unclear, however, whether perceptual nonverbal dominance varies between individuals and whether it is linked to emotional intelligence. Using audiovisual stimulus material comprising verbal and nonverbal emotional cues that were varied independently, perceptual nonverbal dominance profiles and their relations to emotional intelligence were examined. Nonverbal dominance was found in every participant, ranging from 55 to 100%. Moreover, emotional intelligence, particularly the ability to understand emotions, correlated positively with nonverbal dominance. Furthermore, higher overall emotional intelligence as well as a higher ability to understand emotions were linked to smaller reaction time differences between emotionally incongruent and congruent stimuli. The association between perceptual nonverbal dominance and emotional intelligence, and more specifically the ability to understand emotions, might reflect an adaptive process driven by the experience of higher authenticity in nonverbal cues.     

Sex differences in scanning faces: Does attention to the eyes explain female superiority in facial expression recognition?

Previous meta-analyses support a female advantage in decoding non-verbal emotion (Hall, 1978, 1984), yet the mechanisms underlying this advantage are not understood. The present study examined whether the female advantage is related to greater female attention to the eyes. Eye-tracking techniques were used to measure attention to the eyes in 19 males and 20 females during a facial expression recognition task. Women were faster and more accurate in their expression recognition compared with men, and women looked more at the eyes than men. Positive relationships were observed between dwell time and number of fixations to the eyes and both accuracy of facial expression recognition and speed of facial expression recognition. These results support the hypothesis that the female advantage in facial expression recognition is related to greater female attention to the eyes.     

Who do you trust? The impact of facial emotion and behaviour on decision making

During social interactions, we use available information to guide our decisions, including behaviour and emotional displays. In some situations, behaviour and emotional displays may be incongruent, complicating decision making. This study had two main aims: first, to investigate the independent contributions of behaviour and facial displays of emotion on decisions to trust, and, second, to examine what happens when the information being signalled by a facial display is incongruent with behaviour. Participants played a modified version of the Trust Game in which they learned simulated players’ behaviour with or without concurrent displays of facial emotion. Results indicated that displays of anger, but not happiness, influenced decisions to trust during initial encounters. Over the course of repeated interactions, however, emotional displays consistent with an established pattern of behaviour made independent contributions to decision making, strengthening decisions to trust. When facial display and behaviour were incongruent, participants used current behaviour to inform decision making.     

Reducing emotional reasoning: An experimental manipulation in individuals with fear of spiders

We investigated the effects of smiling on perceptions of positive, neutral and negative verbal statements. Participants viewed computer-generated movies of female characters who made angry, disgusted, happy or neutral statements and then showed either one of two temporal forms of smile (slow vs. fast onset) or a neutral expression. Smiles significantly increased the perceived positivity of the message by making negative statements appear less negative and neutral statements appear more positive. However, these smiles led the character to be seen as less genuine than when she showed a neutral expression. Disgust + smile messages led to higher judged happiness than did anger + smile messages, suggesting that smiles were seen as reflecting humour when combined with disgust statements, but as masking negative affect when combined with anger statements. These findings provide insights into the ways that smiles moderate the impact of verbal statements.     

When the face fits: Recognition of celebrities from matching and mismatching faces and voices

The results of two experiments are presented in which participants engaged in a face-recognition or a voice-recognition task. The stimuli were face–voice pairs in which the face and voice were co-presented and were either “matched” (same person), “related” (two highly associated people), or “mismatched” (two unrelated people). Analysis in both experiments confirmed that accuracy and confidence in face recognition was consistently high regardless of the identity of the accompanying voice. However accuracy of voice recognition was increasingly affected as the relationship between voice and accompanying face declined. Moreover, when considering self-reported confidence in voice recognition, confidence remained high for correct responses despite the proportion of these responses declining across conditions. These results converged with existing evidence indicating the vulnerability of voice recognition as a relatively weak signaller of identity, and results are discussed in the context of a person-recognition framework.