Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients
Journal of Plastic, Reconstructive & Aesthetic Surgery
Elsevier for British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)
Reason for embargo
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 eight months later. Participants completed measures of appearance concern and psychological distress (post-traumatic stress symptoms, depressive symptoms, anxiety symptoms). Participants were classified by site of injury (facial or non-facial injury). 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 Eight 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 the 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.
This work was supported by The Facial Surgery Research Foundation – Saving Faces. The authors acknowledge the support of the Centre for Trauma Sciences at Queen Mary University of London for enabling fieldwork to be undertaken. The authors acknowledge the support of Mr Peter McDermott, surgeon, for rating the photographs.
This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.
Published online 16 August 2017