An exceptionally complex object which constantly changes in response to the external stimuli, whilst maintaining fixed elements to ensure its physical configuration and physiognomy, a human face is a significant contributor to human interaction. Both invariant and changeable aspects of face are perceived by others who can ascribe different meanings to them.1, 2, 3
Before a set of facial cues becomes a social message playing an important role in interaction, these have to undergo complex processing algorithms. Currently, there are three main research and applied concepts to explain these algorithms by means of e.g. the underlying neural processes: the Bruce and Young model of face recognition, the Haxby model and the concept of configural processing by Maurer, Le Grand and Mondloch.4
The Bruce and Young’s model indicates that face processing may lead to face recognition and person identification. The face recognition units and person identity nodes are markedly different which becomes particularly obvious during the exposure to various input structural codes (e.g. physical features, voice and speech, and clothing items). It should be noted that even if a person is unknown, some person identity nodes may still be activated; for instance, it is still possible to determine their sex, age, health condition, ethnicity or intelligence. However, the situation is completely different when a person is familiar, as only person identity nodes are activated then at all stages of face processing.5, 6
On the other hand, the Haxby model7 emphasises neural systems of face perception. Face processing involves a number of distributed cerebral structures, which enable person identification. This model differentiates between the invariant and changeable aspects of faces. The invariant aspects of faces are of genetic origin, and as such are predetermined by widely understood inheritance. In an interaction, they may serve as cues to determine personal details, certain biographic aspects or unique identifiers. These aspects are processed primarily by the lateral fusiform gyrus and anterior temporal regions. The neural system responsible for processing the changeable aspects of faces, such as eye gaze, lip movement, spatially directed attention, prelexical speech and emotional expression, is more complex and includes such key structures as the superior temporal sulcus, the intraparietal sulcus, the auditory cortex, the amygdala, the insula and the limbic system.7, 8
The concept of configural processing particularly accentuates the relations between individual parts of the face. The approach postulates three types of configural processing. Initially, the stimulus is assigned to the appropriate first-order relations. Then, the key elements of the perceived stimulus are processed holistically (as gestalt), which forms a single face image. Finally, the second-order relations are identified which require information on relative position, size and colour of face elements. Undoubtedly, this approach assumes the existence of a prototypical face and the possibility to create novel, unique and cognitive representations for each face.9, 10 In the light of the presented face processing models, a question may arise regarding factors contributing to the complexity of this process. Our current understanding links it to the evolutionary changes to the human brain due to interaction with other people, especially the trend to form larger communities.11 In larger communities, mere face recognition may have proved insufficient to serve adaptive action. The face is no longer a purely physical object; at times it is affected by emotions, but it has become the source of information that extends far beyond its directly available physical aspect. As pointed out by Gibson,12 other people’s faces provide a set of adaptive cues that guide social perceptions and enable appropriate response in an interaction. In most cases, these cues are processed in an uninterrupted manner. However, Zebrowitz and Montepare13 notice that there are situations, in which perceiver’s attunement to stimulus information may be needed, resulting in overgeneralised perceptions. Two of them have been explored in particular, i.e. the anomalous face and the babyface overgeneralisation effect.14
Facial attractiveness is one of the most well-researched aspects of cognitive psychology. Better looking people are undoubtedly perceived more positively across all dimensions. They may, for instance, receive more favourable reactions from the community.15, 16 On the other hand it should be mentioned that faces perceived as unattractive resemble those with genetic anomalies which often results in such trait inferences as lower emotional warmth, physical weakness or lower competence.17
Another phenomenon, which may give rise to the overgeneralisation effect, is the so-called ‘babyface’. A mere encounter of a babyface triggers positive responses.18, 19 A babyface is described as rounder, with a narrow chin, higher forehead, smaller nose and plump lips. Furthermore, the babyface phenotype entails larger eyes and high raised eyebrows. Such a constellation of features at least partially noticeable on an adult face may trigger the impression that such a person is warm, caring and honest, yet also less intellectually and socially competent.14, 20
As shown above, facial cues may affect one’s relations with others in a complex way. Face processing can not only lead to recognising the stimulus as a human face but also to trait inferencing, even if the beliefs are unfounded. The ultimate result is a set of features which enable one to adapt to the interaction with someone they have appraised.
The overgeneralisation effect may have detrimental consequences for the social functioning of individuals with facial anomalies. A comprehensive review of these consequences may be found in the article by Riklin, Andover and Annunziato,21 who focused on the psychosocial functioning of adolescents with craniofacial conditions (CFCs). In their proposed psychosocial model of social dysfunction in adolescents with CFCs, they provide a clear hypothesised pathway to explain possible social maladjustment in this group, identifying possible perpetuating factors such as unattractive facial appearance, social stigma as well as lack of social awareness and understanding among their peers. They ultimately lead to loneliness, low self-confidence and lack of social support.21, 22
However, not all individuals with facial anomalies experience the negative consequences of overgeneralisation. Numerous studies show that where facial appearance changes as a result of cancer treatment or blindness, the social response may be exceptionally positive. This may, at least partly, be explained by better awareness of cancer treatments and situation of such individuals.23 A few studies have shown that facial anomalies in children do not necessarily lead to negative overgeneralisation. For individuals with numerous yet minor anomalies, these ‘defects’ may even go disregarded/ unnoticed. This phenomenon was demonstrated to occur in mothers and teachers directly involved with children with moderate learning disability presenting numerous facial anomalies.10, 24 It shows that the overgeneralisation effect is a complex phenomenon underscored by multiple factors and its mechanisms have not as yet been explained.
The aim of the study was to assess the size of the overgeneralisation effect in the perception of a child with CFM by medical university students and people who are close to the child.
The practical aim was to indicate the legitimacy of considering the role of the overgeneralisation effect at the beginning of the treatment and the rehabilitation process of a child with facial and body deformities to improve the effectiveness of treatment and rehabilitation. The size of the discrepancies shows how the rehabilitation process will look like in the interpersonal dimension (climate, emotions, interpersonal communication with relatives and the child). Reducing the discrepancies in the images shaped by specialists and caregivers of children with CFM can help improve the effectiveness of the treatment and the rehabilitation process.
The study group consisted of 843 university students and 26 parents/carers of children with craniofacial microsomia (
Parents/carers were surveyed during the conference for parents/carers of children with
The participation in the study was voluntary, and the study was made with the consent of the participants. This scientific project was approved by the Independent Bioethical Committee for Scientific Research at the Medical University of Gdańsk (NKBBN/48/2017, NKBBN/178/2018) and the management of the Provincial Specialist Children’s Hospital named after
Characteristics of enrolled students and parents/carers of children with CFM.
University Department/ Programme | Group size ( |
Group size (%) | ||
---|---|---|---|---|
Medicine | 568 | 86 | 482 | 65.22% |
Dentistry | 130 | 10 | 120 | 16.24% |
Nursing | 100 | 6 | 94 | 12.72% |
Health psychology | 45 | 2 | 43 | 5.82% |
Total | 843 | 104 | ||
Parents/Carers of children with CFM | 26 | 8 |
Prof. Stanisław Popowski in Olsztyn. The participants who did not respond to at least one item (a pair of adjectives) in
Having provided their written consent to participate in the study, the participants were requested to complete the Milska and Mański’s
The reliability of
Student responses provided a relatively variable child trait profile (Figure 1). Whereas the
Mean values (
Parent/carer responses provided a highly invariable trait profile of a child (Figure 1). Whereas the
Comparing the individual
Mean values (
From a psychological point of view, facial and thoracic anomalies may be considered in connection with stigma. As pointed by Goffman,26 in certain circumstances minor and major deformities may become a stigma, a mark of social disgrace. This paper provides a comparison and analysis of responses on trait inferencing about a child with
As Zebrowitz indicates,3 the physical appearance is one of the first aspects that people base their trait impressions and inferences on, which poses the risk for significantly distorted and superficial appraisals. On the other hand, despite strong evidence for the effect of some facial cues on perceiver’s trait impressions, their contribution to overgeneralisation effect remains unconscious. Many authors point out that overgeneralisation effect can be evoked in response to such cues as a babyface or strong childlike features on an adult’s face, familiar face, fitness traits and emotional expression.27, 28, 29, 30 The diversity of our results can be at least partly explained by this set of cues. Our participants were to appraise a child with
For the close relatives, though, this role is completely different, hence the trait profile with a clearly positive and internally consistent score distribution offers an opportunity to encourage behaviours beyond the standard treatment and rehabilitation. Thinking of adaptation, it should be noted that the trait profile provided by parents/carers is particularly positive. As shown by Mański,2 mothers of children with numerous facial anomalies tend not to notice or disregard these anomalous features. Therefore, their further appraisals and inferences may be determined by the facial stimulus after a ‘deformity retouch’. It may be, e.g. a face of the child the mother dreamt and created an internal image of before the actual child with genetic defect was born. For the students, on the other hand, the appraisal of the child in the photograph is likely the result of comparison with other children they encountered during their training or in private life. This variety of sources could translate into internally inconsistent score profile in students.
As indicated by Kowalik,36 the rehabilitation process entails an interaction between e.g. patients, their relatives, doctors, physiotherapists, nurses or psychologists. Each participant brings knowledge of themselves, of the situation and of themselves in the situation into the interaction. Where there are so many, often clashing, perspectives, the atmosphere may be created which is conducive or detrimental to treatment. Any discrepancies may be minimised through negotiations, which also affect the overgeneralised image of a patient.37 The trait profiles of a child with
The professional appraisal of a child with
The rehabilitation process entails an interaction between e.g. patients, their relatives and professionals (doctors, physiotherapists, nurses or psychologists).
The trait profiles of a child with
The perception of children with
The professional appraisal of a child with
An attempt to reduce the differences in the perception of a child with