Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients

Abstract

Facial injuries are widely assumed to lead to stigma and significant psychosocial burden. Experimental studies of face perception support this idea, but there is very little empirical evidence to guide treatment. This study sought to address the gap. Data were collected from 193 patients admitted to hospital following facial or other trauma. Ninety (90) participants were successfully followed up 8 months later. Participants completed measures of appearance concern and psychological distress (post-traumatic stress symptoms (PTSS), depressive symptoms, anxiety symptoms). Participants were classified by site of injury (facial or non-facial injury). The overall levels of appearance concern were comparable to those of the general population, and there was no evidence of more appearance concern among people with facial injuries. Women and younger people were significantly more likely to experience appearance concern at baseline. Baseline and 8-month psychological distress, although common in the sample, did not differ according to the site of injury. Changes in appearance concern were, however, strongly associated with psychological distress at follow-up. We conclude that although appearance concern is severe among some people with facial injury, it is not especially different to those with non-facial injuries or the general public; changes in appearance concern, however, appear to correlate with psychological distress. We therefore suggest that interventions might focus on those with heightened appearance concern and should target cognitive bias and psychological distress.

The association of affective disorders and facial scarring: Systematic review and meta-analysis

“…Several papers in this review demonstrated female gender to be associated with higher rates of psychopathology [18,23,24], a finding that is in keeping with general population studies (Bottomley et al, 2010;Merikangas et al, 2011). Other work has shown that females score higher on measures of maladaptation to disfigurement than males (Rahtz et al, 2018). Therefore, it may be that there is a composite relationship of female gender and facial scarring in the risk for developing psychopathology.…”

Effectiveness of Cognitive Behavior Therapy Combined with Eye Movement Desensitization and Reprocessing on Psychological Problems and Life Quality in Patients’ Postfacial Trauma

“…According to clinical researches, about 20%-30% patients with facial trauma show the symptoms and signs of anxiety [ 28 , 29 ]. Moreover, patients with facial trauma showed increased PTSD incidence compared with the general population [ 30 , 31 ]. In our study, we found that patients with facial trauma exhibited evident short-term symptoms of depression and anxiety.…”

Patient-reported Outcomes in Facial Reconstruction: Assessment of FACE-Q Scales and Predictors of Satisfaction

“…8,18 Nonetheless, it is noteworthy that facial trauma patients, many of whom have significant facial disfigurement, report higher satisfaction with facial appearance when compared with patients seeking facial aesthetic surgery. 19 The composition of the “Other” injury mechanism group (gunshots, dogbites, forklift trauma) likely explains their lower scores. It is unclear why longer duration from surgery is associated with lower scores on this scale.…”