Beyond the face: An interdisciplinary evaluation of satisfaction with appearance in young people with orofacial clefts

Abstract

Orofacial clefts are the most common congenital anomaly of the face, and they significantly affect appearance. The combined effects of demographics, psychology, neurophysiology, and cleft characteristics to explain satisfaction with appearance in young people with a cleft have not yet been comprehensively studied in an interdisciplinary manner. We found that interpersonal difficulties, age, and conscientiousness were significant explanatory factors for satisfaction with appearance (t_{interpersonal difficulties} = -3.022, p = 0.006; t_age = -3.563, p = 0.016; t_{conscientiousness} = 4.161, p = 0.003); the model explained 50% of variance in satisfaction with appearance (R² _Adjusted = 0.504, F_{vs. constant} = 4.05, p = 0.00117). Furthermore, frontal alpha asymmetry was complexly intertwined with other variables, affecting the overall accuracy of the model, but explaining only 10.5% of variance in satisfaction with appearance when used as a factor alone. The results show that an interdisciplinary approach can substantially expand our understanding of the factors influencing self-perception in young people with orofacial clefts.

Keywords: Neuroscience; Psychology; Sensory neuroscience; Social sciences.

Graphical abstract

Figure 1

An adjusted partial regression plot for the model testing the effects of frontal alpha asymmetry (FAA), neuroticism and interpersonal difficulties (VMTM all) on satisfaction with appearance in young people with a cleft (CHASQ), while controlling for the effects of other psychological, socio-economic, and demographic variables The plots show the adjusted effects of each variable included in the model, meaning that all influence of the other variables included in the model has been removed, showing the isolated effect of the variable depicted. Red circles with black borders represent individual data points (F_{vs. constant} = 4.05, df = 26, p = 0.00117, N = 40 participants), also adjusted to eliminate the effects of other variables. The gray dash-and-dot lines represent the adjusted regression fit for each variable. The bottom right panel shows the adjusted plot for the entire model. There, the black dashed lines represent the 95% confidence interval for the whole-model regression fit (dash-and-dot gray line). The variables are grouped into categorical (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface), interpersonal difficulties (marked with a light green surface) and neurophysiology (orange surface). The non-colored surface covered graph is the adjusted whole model. All plots have the adjusted CHASQ values as their y axis. An ∗ marks a significant effect.

Figure 2

This figure depicts the main effects of the regression model testing the effects of frontal alpha asymmetry, neuroticism and interpersonal difficulties on their satisfaction with appearance, while controlling for the effects of other psychological, socio-economic and demographic variables (F_{vs. constant} = 4.05, df = 26, p = 0.00117, N = 40 participants) The main effect (x axis) shows the total isolated effect of each variable (black circles), when all other variables in the model have been controlled for. This means that the effects depicted show how much the entire span of the variable has affected satisfaction with appearance. The black capped lines represent 95% confidence intervals for the effects. Red ellipses represent significant effects, at the α = 0.05 level, after the Bonferroni correction was applied. Please note that for this reason, diagnosis is not marked as significant, although its 95% confidence interval does not intersect with the dotted line. The variables are grouped into demographic (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface), interpersonal difficulties (marked with a light green surface) and neurophysiology (orange surface). FAA = frontal alpha asymmetry.

Figure 3

An adjusted partial regression plot for the model testing the effects of neuroticism and interpersonal difficulties (VMTM all) on satisfaction with appearance of young people with a cleft (CHASQ), while controlling for the effects of other psychological, socio-economic, and demographic variables on an extended sample of young people with a cleft (F_{vs. constant} = 2.52, df = 42, p = 0.0136, N = 55 participants) The plots show the adjusted effects of each variable included in the model, meaning that all influence of the other variables included in the model has been removed, showing the isolated effect of the variable depicted. Red circles with black borders represent individual data points, also adjusted to eliminate the effects of other variables. The gray dash-and-dot lines represent the adjusted regression fit for each variable. The bottom right panel shows the adjusted plot for the entire model. There, the black dashed lines represent the 95% confidence interval for the whole-model regression fit (dash-and-dot gray line). The variables are grouped into categorical (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface) and interpersonal difficulties (marked with a light green surface). The non-colored surface covered graph is the adjusted whole model. All plots have the adjusted CHASQ values as their y axis. An ∗ marks a significant effect.

Figure 4

This figure depicts the main effects of the regression model testing the effects of frontal alpha asymmetry, neuroticism and interpersonal difficulties on their satisfaction with appearance, while controlling for the effects of other psychological, socio-economic and demographic variables (F_{vs. constant} = 2.52, df = 42, p = 0.0136, N = 55 participants) The main effect (x axis) shows the total isolated effect of each variable (black circles), when all other variables in the model have been controlled for. This means that the effects depicted show how much the entire span of the variable has affected satisfaction with appearance. The black capped lines represent 95% confidence intervals for the effects. Red ellipses represent significant effects, at the α = 0.05 level, after the Bonferroni correction was applied. The variables are grouped into demographic (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface) and interpersonal difficulties (marked with a light green surface). FAA = frontal alpha asymmetry.

Figure 5

An adjusted partial regression plot for the model testing the effects of neuroticism and interpersonal difficulties (VMTM all) on satisfaction with appearance of young people with a cleft (CHASQ), while controlling for the effects of other psychological, socio-economic and demographic variables, and using the sample for which electroencephalography data is available but excluding this data from the model (F_{vs. constant} = 2.77, df = 28, p = 0.0128, N = 41 participants) The plots show the adjusted effects of each variable included in the model, meaning that all influence of the other variables included in the model has been removed, showing the isolated effect of the variable depicted. Red circles with black borders represent individual data points, also adjusted to eliminate the effects of other variables. The gray dash-and-dot lines represent the adjusted regression fit for each variable. The bottom right panel shows the adjusted plot for the entire model. There, the black dashed lines represent the 95% confidence interval for the whole-model regression fit (dash-and-dot gray line). The variables are grouped into categorical (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface) and interpersonal difficulties (marked with a light green surface). The non-colored surface covered graph is the adjusted whole model. All plots have the adjusted CHASQ values as their y axis. An ∗ marks a significant effect.

Figure 6

This figure depicts the main effects of the regression model testing the effects of neuroticism and interpersonal difficulties on their satisfaction with appearance, while controlling for the effects of other psychological, socio-economic and demographic variables The main effect (x axis) shows the total isolated effect of each variable (black circles), when all other variables in the model have been controlled for (F_{vs. constant} = 2.77, df = 28, p = 0.0128, N = 41 participants). This means that the effects depicted show how much the entire span of the variable has affected satisfaction with appearance. The black capped lines represent 95% confidence intervals for the effects. Red ellipses represent significant effects, at the α = 0.05 level, after the Bonferroni correction was applied. The variables are grouped into demographic (marked with a blue surface), cleft type (marked with a red surface), personality (marked with a lavender surface) and interpersonal difficulties (marked with a light green surface). FAA = frontal alpha asymmetry.

Figure 7

The results of univariate regression of frontal alpha asymmetry (FAA) to satisfaction with appearance in young people with a cleft (CHASQ) The top panel shows the adjusted partial regression plot without the effects of the intercept; the blue line represents the regression fit and the red dots the individual data points (F_{vs. constant} = 6.39, df = 45, p = 0.015, N = 47 participants). The bottom panel shows the main effect plot, with the red ellipse indicating significance. The orange color shows that this variable represents neurophysiology of young people with clefts.

Figure 8

The results of the post-hoc comparisons for the one-way ANOVA on the data on the CHASQ, conscientiousness and interpersonal difficulties of young people with a cleft (N = 70 participants) An ∗ symbol in the panel denotes a significant difference (Interpersonal difficulties, t = 2.103, df = 67, p = 0.0392). The plots depict the median, the lower and upper quartiles, any outliers (computed using the interquartile range), and the minimum and maximum values that were not outliers. The tapered, shaded notch serves as a visual indicator of the significance of the differences, where box charts whose notches do not overlap have different medians at the 5% significance level. CLP = cleft lip and palate, CP = cleft palate only, CLA = cleft lip and alveolus, CHASQ = Cleft Hearing, Appearance, and Speech Questionnaire.