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O'Rourke SP, Stack TJ, Miller JR, Miller MQ. Changes in Perceived Emotions in Facial Paralysis Patients After Depressor Anguli Oris Excision. Laryngoscope 2024; 134:4028-4035. [PMID: 38706403 DOI: 10.1002/lary.31471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/23/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Depressor anguli oris (DAO) excision can improve clinician-graded, objective, and patient-reported smile outcomes in patients with nonflaccid facial paralysis (NFFP). However, no prior research has studied changes in perceived emotions after surgery. This study quantifies changes in perceived emotions with smiling after DAO excision in the largest case series presented to date. METHODS Prospectively collected data from patients with NFFP who underwent DAO excision at a tertiary care facial nerve center were reviewed. Patient-reported, clinician-graded, and objective smile metrics were compared before and after surgery. Videos of faces at rest and while smiling were analyzed by artificial intelligence-derived facial expression analysis software to quantify perceived emotions. RESULTS Sixty-eight patients underwent isolated DAO excision between August 2021 and August 2023. Patients conveyed significantly more perceived happiness with smile and at rest after surgery (p < 0.001 and p = 0.012, respectively). DAO excision improved oral commissure excursion (p < 0.001), dental show (p < 0.001), and smile angle (p < 0.001) symmetry. Patients reported significant improvements in smiling and social function after surgery. CONCLUSIONS This study demonstrates DAO excision increases perceived happiness conveyed by patients with NFFP while smiling and at rest. It confirms improved objective, clinician-graded, and patient-reported smile outcomes after surgery. LEVEL OF EVIDENCE 4 Laryngoscope, 134:4028-4035, 2024.
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Heerey EA, Clerke AS, Johnson NJ, Patenaude J. The subjective value of genuine smiles guides real-world social behaviour. PLoS One 2024; 19:e0304726. [PMID: 38861570 PMCID: PMC11166336 DOI: 10.1371/journal.pone.0304726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/16/2024] [Indexed: 06/13/2024] Open
Abstract
The mechanisms that underpin human social behaviour are poorly understood, in part because natural social behaviour is challenging to study. The task of linking the mechanisms thought to drive social behaviour to specific social behaviours in a manner that maintains ecological validity poses an even greater challenge. Here we report evidence that the subjective value people assign to genuine smiles, as measured in the laboratory, determines their responsiveness to genuine smiles encountered in a naturalistic social interaction. Specifically, participants (university undergraduates; age 17 to 36) who valued genuine smiles to a greater degree also showed stronger attention capture effects to neutral faces that were previously associated with genuine smiles and faster reciprocity of a social partner's smiles in a real social interaction. Additionally, the faster participants responded to the partner's genuine smiles the higher the partner's ratings of interaction quality were after the interaction. These data suggest that individual differences in subjective value of genuine smiles, measured in the lab, is one element that underpins responsiveness to natural genuine smiles and subsequent social outcomes.
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Pezzotti E, Provenzi L, Naboni C, Capelli E, Ghirardello S, Borgatti R, Orcesi S. Masked or not, I smile to you: Exploring full-term and preterm infants' social smiles to adults wearing a protective facemask. Infant Behav Dev 2024; 75:101947. [PMID: 38593528 DOI: 10.1016/j.infbeh.2024.101947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
The early emergence of social smiles is an important milestone of infants' socio-emotional development. Our aim was to assess how the use of protective facemasks by adults affects the display of social smiles in preterm (PT) and full-term (FT) infants at 3 months (corrected age for prematurity). We enrolled 30 FT and 30 PT infants (gestational age ≤ 32 weeks). Infants' social smiles displays were assessed at 2-3-month-age (corrected) across a three-episode (masked mother; unmasked mother; masked adult female stranger) videotaped interactive task. During each episode, the adult was instructed to maintain specific facial expressions (happy-smiling, sad-frowning, neutral-unresponsive) for 15 second windows and then instructed to interact spontaneously for 45 s (of which the first 15 s were coded). FT and PT infants did not differ in the display of social smiles. In both groups, social smiles were mostly exhibited in response to happy/smiling and spontaneously interacting partners. Overall, no effect of wearing a protective facemask emerged. The use of protective facemasks did not result in a lower display of social smiles. The findings suggest that FT and PT might be equally sensitive to their adult interactive partners in terms of social smiles displays at 2-3-month-age.
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Ahn YA, Ertuğrul IÖ, Chow SM, Cohn JF, Messinger DS. Automated measurement of infant and mother Duchenne facial expressions in the Face-to-Face/Still-Face. INFANCY 2023; 28:910-929. [PMID: 37466002 PMCID: PMC10426229 DOI: 10.1111/infa.12556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Although still-face effects are well-studied, little is known about the degree to which the Face-to-Face/Still-Face (FFSF) is associated with the production of intense affective displays. Duchenne smiling expresses more intense positive affect than non-Duchenne smiling, while Duchenne cry-faces express more intense negative affect than non-Duchenne cry-faces. Forty 4-month-old infants and their mothers completed the FFSF, and key affect-indexing facial Action Units (AUs) were coded by expert Facial Action Coding System coders for the first 30 s of each FFSF episode. Computer vision software, automated facial affect recognition (AFAR), identified AUs for the entire 2-min episodes. Expert coding and AFAR produced similar infant and mother Duchenne and non-Duchenne FFSF effects, highlighting the convergent validity of automated measurement. Substantive AFAR analyses indicated that both infant Duchenne and non-Duchenne smiling declined from the FF to the SF, but only Duchenne smiling increased from the SF to the RE. In similar fashion, the magnitude of mother Duchenne smiling changes over the FFSF were 2-4 times greater than non-Duchenne smiling changes. Duchenne expressions appear to be a sensitive index of intense infant and mother affective valence that are accessible to automated measurement and may be a target for future FFSF research.
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Babeer WA, Bakhsh ZT, Natto ZS. The perception of smile attractiveness to altered vertical position of maxillary anteriors by various groups. Medicine (Baltimore) 2022; 101:e28660. [PMID: 35244035 PMCID: PMC8896490 DOI: 10.1097/md.0000000000028660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 01/05/2022] [Indexed: 01/04/2023] Open
Abstract
There is a gap in research about the differences in smile attractiveness. The problem the study addresses is how the vertical canine and incisor position affect smile attractiveness. The aim of this study was to assess the perception of the smile attractiveness between Saudi laypersons, orthodontists, non-orthodontist, and various dental students levels, and to determine how the canine and incisor vertical positions affect the attractiveness of smile. The study is a cross-sectional survey and was conducted at King Abdulaziz University, Jeddah, Saudi Arabia. Six groups of subjects participated in the study: Orthodontic residents (n = 31), prosthodontic, restorative, periodontics specialties residents specialties residents (n = 30), interns (n = 31), fifth year students (n = 41), 6th year students (n = 39), and laypeople (n = 39). Participants were asked to rate the attractiveness of a smile of a female subject photographed using a Minolta DiMage 7i digital camera. The image had been manipulated to produce 2 sets of images; 1 to modify the incisors and 1 to change the canines. The subjects were asked to choose the most and least attractive picture. For the best incisor positions, only the laypeople and prosthodontics liked the original picture, the rest liked +0.5 mm which accentuate the smile curve and make it follow the lower lip line. For the worst incisor position, all groups did not prefer the minus 1.5 reversed smile. For the best canine vertical position, all groups preferred the original position where canine was at the level of the incisal plane. For the worst canine position, they all disliked the minus 1.5 reversed smile. Results confirmed past findings that orthodontists are in general more critical about smile attractiveness than laypersons, but just like other dental specialists. The findings can be used in the esthetic dentistry field, but further research on the study population based on other dental design parameters remain necessary.
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Marler H, Ditton A. "I'm smiling back at you": Exploring the impact of mask wearing on communication in healthcare. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:205-214. [PMID: 33038046 PMCID: PMC7675237 DOI: 10.1111/1460-6984.12578] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Surgical and respirator masks are worn to reduce the risk of droplet and airborne transmission of viral respiratory disease. As a result of the novel coronavirus (COVID-19) pandemic, mask wearing has been designated mandatory for healthcare professionals working in UK hospitals for the foreseeable future. It is thus timely to consider the long-term implications of mask wearing on communication within healthcare settings, from both a patient and a clinician perspective. AIMS The primary objective is to identify research evidence that corresponds to the mask-wearing experiences of healthcare professionals working on the ground. By drawing together a summary of the literature illustrating the potential challenges associated with mask wearing, it is possible to make an application to various clinical cohorts and to formulate a set of preliminary, evidence-based support strategies. The paper additionally explores the role for the Speech and Language Therapist (SLT) in supporting communication in the context of mask wearing. METHODS & PROCEDURES Through a scoping review of the relevant literature, this paper reflects holistically on the prospective challenges associated with mask wearing across a variety of healthcare settings and patient populations. The subsequent conclusions have been used to inform the proposed clinical guidelines for safe and effective practice. OUTCOMES & RESULTS There is a current research gap with regards to mask wearing in non-medical and non-clinical healthcare workers, and the impact this may have on both a professional and a personal basis. In the absence of preliminary data, the development of associated communication support strategies is hindered. This paper draws upon a variety of clinically conceivable issues faced by healthcare professionals, outlines important practical and ethical considerations, and proposes evidence-based solutions to some of the challenges identified. Future research is required to gather evidence with regards to actual clinical experiences of mask wearing to substantiate hypotheses. CONCLUSIONS & IMPLICATIONS Although undoubtedly essential in protecting the health of staff and patients, there are numerous logistical, physiological, psychological, social and economic complications associated with the wearing of masks. The ability of healthcare staff to successfully communicate with patients and with colleagues is jeopardized, which may adversely affect the efficiency, effectiveness, equitability and, most notably, safety of therapeutic intervention. The SLT has a distinct role in facilitating communication in order to safeguard the provision, accessibility and efficacy of services. What this paper adds What is already known on the subject Existing research explores the impact of mask wearing on medical doctors, surgeons and dentists, and upon the corresponding patient cohorts. Little is known about how mask wearing may affect Allied Health Professionals and their ability to deliver therapeutic interventions safely and effectively. With mandatory face covering potentially a long-term requirement for UK healthcare staff, it is both timely and relevant to consider the consequences of mask wearing on communication across acute and community settings. What this paper adds to existing knowledge This paper identifies a range of prospective key issues associated with mask wearing across a variety of clinical and non-clinical populations, with application specifically to vulnerable patient cohorts. Through evidence synthesis, this paper provides a summary of fundamental issues supported by relevant literature, and draws upon these in order to propose a preliminary set of evidence-based clinical guidelines setting out potential solutions to the challenges faced. This review additionally assists in quantifying the role of the SLT within these extraordinary circumstances, with the aim of prompting unified practice, building upon professional guidance and increasing skill recognition. What are the potential or actual clinical implications of this work? In addition to their role in facilitating the development of individualised communication strategies for patients, SLTs should actively seek to provide widely accessible multidisciplinary education opportunities focusing on supporting communication; with specific reference to mask wearing and the associated communicative challenges. At a commissioning and managerial level, leaders within healthcare should acknowledge mask wearing as just one of the complexities associated with frontline working in the context of the COVID-19 pandemic, and aim to support their workforce by delivering resources and protocols which maximize and promote staff safety, efficiency, resilience and well-being in concurrence with positive patient outcomes.
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Miller EJ, Krumhuber EG, Dawel A. Observers perceive the Duchenne marker as signaling only intensity for sad expressions, not genuine emotion. ACTA ACUST UNITED AC 2020; 22:907-919. [PMID: 32718174 DOI: 10.1037/emo0000772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Duchenne marker-crow's feet wrinkles at the corner of the eyes-has a reputation for signaling genuine positive emotion in smiles. Here, we test whether this facial action might be better conceptualized as a marker of emotional intensity, rather than genuineness per se, and examine its perceptual outcomes beyond smiling, in sad expressions. For smiles, we found ratings of emotional intensity (how happy a face is) were unable to fully account for the effect of Duchenne status (present vs. absent) on ratings of emotion genuineness. The Duchenne marker made a unique direct contribution to the perceived genuineness of smiles, supporting its reputation for signaling genuine emotion in smiling. In contrast, across 4 experiments, we found Duchenne sad expressions were not rated as any more genuine or sincere than non-Duchenne ones. The Duchenne marker did however make sad expressions look sadder and more negative, just like it made smiles look happier and more positive. Together, these findings argue the Duchenne marker has an important role in sad as well as smiling expressions, but is interpreted differently in sad expressions (contributions to intensity only) compared with smiles (emotion genuineness independently of intensity). (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Parsa KM, Hancock M, Nguy PL, Donalek HM, Wang H, Barth J, Reilly MJ. Association of Facial Paralysis With Perceptions of Personality and Physical Traits. JAMA Netw Open 2020; 3:e205495. [PMID: 32579192 PMCID: PMC7315303 DOI: 10.1001/jamanetworkopen.2020.5495] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Facial paralysis has a significant effect on affect display, with the most notable deficit being patients' the inability to smile in the same way as those without paralysis. These impairments may result in undesirable judgements of personal qualities, thus leading to a significant social penalty in those who have the condition. OBJECTIVE To quantify the association of facial paralysis with the way smiling patients are perceived by others with respect to personality traits, attractiveness, and femininity or masculinity and to evaluate the potential association of facial palsy-related patient-reported outcome measures with how patients are perceived by others. DESIGN, SETTING, AND PARTICIPANTS This retrospective cross-sectional study used 20 images of smiling patients with facial paralysis evaluated between January 1, 2014, and December 31, 2016. Using photograph editing software, the photographs were edited to create a simulated nonparalysis smiling facial appearance. A total of 40 photographs were split into 4 groups of 10 photographs, each with 5 altered and 5 unaltered photographs. The surveys were designed such that altered and unaltered photographs of the same patient were not placed in the same survey to avoid recall bias. Anonymous raters used a 7-point Likert scale to rate their perception of each patient's personality traits (ie, aggressiveness, likeability, and trustworthiness), attractiveness, and femininity or masculinity based on photographs in their assigned survey. Raters were blinded to study intent. Scores from the Facial Clinimetric Evaluation questionnaire were included to assess self-perception. Data were analyzed from November 11, 2019, to February 20, 2020. MAIN OUTCOMES AND MEASURES Ratings of personality traits, attractiveness, and femininity or masculinity. Social function domain scores and overall scores were analyzed from the Facial Clinimetric Evaluation questionnaire. RESULTS This study included photographs of 20 patients with facial paralysis (mean [range] age, 54 [28-69] years; 15 [75%] women). A total of 122 respondents completed the survey (71 [61%] women). Most respondents were between the ages of 25 and 34 years (79 participants [65%]). Overall, smiling photos of patients with facial paralysis were perceived as significantly less likeable (difference, -0.29; 95% CI, -0.43 to -0.14), trustworthy (difference, -0.25; 95% CI, -0.39 to -0.11), attractive (difference, -0.47; 95% CI, -0.62 to -0.32), and feminine or masculine (difference, -0.21; 95% CI, -0.38 to -0.03) compared with their simulated preparalysis photographs. When analyzed by sex, smiling women with facial paralysis experienced lower ratings for likeability (difference, -0.34; 95% CI, -0.53 to -0.16), trustworthiness (difference, -0.24; 95% CI, -0.43 to -0.06), attractiveness (difference, -0.74; 95% CI, -0.94 to -0.55), and femininity (difference, -0.35; 95% CI, -0.58 to -0.13). However, smiling men with facial paralysis only received significantly lower ratings for likeability (difference, -0.24; 95% CI, -0.47 to -0.01) and trustworthiness (difference, -0.30; 95% CI, -0.53 to -0.07). As patients' self-reported social function and total Facial Clinimetric Evaluation scores increased, there was an increase in perceived trustworthiness (rs[480] = 0.11; P = .02) and attractiveness (rs[478] = 0.10; P = .04) scores by raters. CONCLUSIONS AND RELEVANCE In this study, photographs of patients with facial paralysis received lower ratings for several personality and physical traits compared with digitally edited images with no facial paralysis. These findings suggest a social penalty associated with facial paralysis.
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Romsics L, Segatto A, Boa K, Becsei R, Rózsa N, Szántó I, Nemes J, Segatto E. Dentofacial mini- and microesthetics as perceived by dental students: A cross-sectional multi-site study. PLoS One 2020; 15:e0230182. [PMID: 32163487 PMCID: PMC7067484 DOI: 10.1371/journal.pone.0230182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/23/2020] [Indexed: 11/18/2022] Open
Abstract
Background How dental education influences students’ dental and dentofacial esthetic perception has been studied for some time, given the importance of esthetics in dentistry. However, no study before has studied this question in a large sample of students from all grades of dental school. This study sought to fill that gap. The aim was to assess if students’ dentofacial esthetic autoperception and heteroperception are associated with their actual stage of studies (grade) and if autoperception has any effect on heteroperception. Methods Between October 2018 and August 2019, a questionnaire was distributed to 919 dental students of all 5 grades of dental school at all four dental schools in Hungary. The questionnaire consisted of the following parts (see also the supplementary material): 1. Demographic data (3 items), Self-Esthetics I (11 multiple- choice items regarding the respondents’ perception of their own dentofacial esthetics), Self-Esthetics II (6 Likert-type items regarding the respondents’ perception of their own dentofacial esthetics), and Image rating (10 items, 5 images each, of which the respondents have to choose the one they find the most attractive). Both the self-esthetics and the photo rating items were aimed at the assessment of mini- and microesthetic features. Results The response rate was 93.7% (861 students). The self-perception of the respondents was highly favorable, regardless of grade or gender. Grade and heteroperception were significantly associated regarding maxillary midline shift (p < 0.01) and the relative visibility of the arches behind the lips (p < 0.01). Detailed analysis showed a characteristic pattern of preference changes across grades for both esthetic aspects. The third year of studies appeared to be a dividing line in both cases, after which a real preference order was established. Association between autoperception and heteroperception could not be verified for statistical reasons. Conclusion Our findings corroborate the results of most previous studies regarding the effect of dental education on the dentofacial esthetic perception of students. We have shown that the effect can be demonstrated on the grade level, which we attribute to the specific curricular contents. We found no gender effect, which, in the light of the literature, suggests that the gender effect in dentofacial esthetic perception is highly culture dependent. The results allow no conclusion regarding the relation between autoperception and heteroperception.
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Perusquía-Hernández M, Ayabe-Kanamura S, Suzuki K. Human perception and biosignal-based identification of posed and spontaneous smiles. PLoS One 2019; 14:e0226328. [PMID: 31830111 PMCID: PMC6907846 DOI: 10.1371/journal.pone.0226328] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 11/25/2019] [Indexed: 11/21/2022] Open
Abstract
Facial expressions are behavioural cues that represent an affective state. Because of this, they are an unobtrusive alternative to affective self-report. The perceptual identification of facial expressions can be performed automatically with technological assistance. Once the facial expressions have been identified, the interpretation is usually left to a field expert. However, facial expressions do not always represent the felt affect; they can also be a communication tool. Therefore, facial expression measurements are prone to the same biases as self-report. Hence, the automatic measurement of human affect should also make inferences on the nature of the facial expressions instead of describing facial movements only. We present two experiments designed to assess whether such automated inferential judgment could be advantageous. In particular, we investigated the differences between posed and spontaneous smiles. The aim of the first experiment was to elicit both types of expressions. In contrast to other studies, the temporal dynamics of the elicited posed expression were not constrained by the eliciting instruction. Electromyography (EMG) was used to automatically discriminate between them. Spontaneous smiles were found to differ from posed smiles in magnitude, onset time, and onset and offset speed independently of the producer's ethnicity. Agreement between the expression type and EMG-based automatic detection reached 94% accuracy. Finally, measurements of the agreement between human video coders showed that although agreement on perceptual labels is fairly good, the agreement worsens with inferential labels. A second experiment confirmed that a layperson's accuracy as regards distinguishing posed from spontaneous smiles is poor. Therefore, the automatic identification of inferential labels would be beneficial in terms of affective assessments and further research on this topic.
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Heerey EA, Gilder TSE. The subjective value of a smile alters social behaviour. PLoS One 2019; 14:e0225284. [PMID: 31790439 PMCID: PMC6886806 DOI: 10.1371/journal.pone.0225284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/31/2019] [Indexed: 11/21/2022] Open
Abstract
Face-to-face social behaviour is difficult to explain, leading some researchers to call it the “dark matter” of psychology/neuroscience [1]. We apply an idea from neuroeconomics to this problem, suggesting that how people subjectively value facial expressions should predict usage differences during unconstrained interaction. Specifically, we ask whether the subjective value of smiles is malleable as a consequence of immediate social experience and how this relates to smiling during face-to-face interactions. We measured the value of a smile in monetary terms and found that increases in people’s social neediness caused devaluation of polite smiles but no changes in how they valued genuine smiles. This result predicts that participants induced to feel high levels of social need should be less responsive to their social partners’ polite smiles in a subsequent unconstrained social interaction. As expected, high social-need participants returned fewer polite smiles when interacting with a partner, leading to poor interaction outcomes. Genuine smile reciprocity remained unchanged. Findings show that social states influence real-world interactions by changing social-cue valuation, highlighting a potential mechanism for understanding the moment-to-moment control of social behaviour and how behaviour changes based on people’s subjective evaluations of the social environment.
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Barceló-Soler A, Baños RM, López-Del-Hoyo Y, Mayoral F, Gili M, García-Palacios A, García-Campayo J, Botella C. Interventions of computerized psychotherapies for depression in Primary Care in Spain. ACTAS ESPANOLAS DE PSIQUIATRIA 2019; 47:236-246. [PMID: 31869424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice.
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Dhara A. Smile! Women as family doctors. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:497-498. [PMID: 31300436 PMCID: PMC6738462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Friesen JP, Kawakami K, Vingilis-Jaremko L, Caprara R, Sidhu DM, Williams A, Hugenberg K, Rodríguez-Bailón R, Cañadas E, Niedenthal P. Perceiving happiness in an intergroup context: The role of race and attention to the eyes in differentiating between true and false smiles. J Pers Soc Psychol 2019; 116:375-395. [PMID: 30614725 DOI: 10.1037/pspa0000139] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present research comprises six experiments that investigated racial biases in the perception of positive emotional expressions. In an initial study, we demonstrated that White participants distinguished more in their happiness ratings of Duchenne ("true") and non-Duchenne ("false") smiles on White compared with Black faces (Experiment 1). In a subsequent study we replicated this effect using a different set of stimuli and non-Black participants (Experiment 2). As predicted, this bias was not demonstrated by Black participants, who did not significantly differ in happiness ratings between smile types on White and Black faces (Experiment 3). Furthermore, in addition to happiness ratings, we demonstrated that non-Black participants were also more accurate when categorizing true versus false expressions on White compared with Black faces (Experiment 4). The final two studies provided evidence for the mediating role of attention to the eyes in intergroup emotion identification. In particular, eye tracking data indicated that White participants spent more time attending to the eyes of White than Black faces and that attention to the eyes predicted biases in happiness ratings between true and false smiles on White and Black faces (Experiment 5). Furthermore, an experimental manipulation focusing participants on the eyes of targets eliminated the effects of target race or perceptions of happiness (Experiment 6). Together, the findings provide novel evidence for racial biases in the identification of positive emotions and highlight the critical role of visual attention in this process. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Cavalcanti SM, Guerra SMG, Valentim FB, Rosetti EP. Esthetic perception of smiles with different gingival conditions. GENERAL DENTISTRY 2019; 67:66-70. [PMID: 30644835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aimed to compare the perceptions of smile esthetics among general practitioners, periodontists, and laypeople. Photographs of smiles were taken and digitally modified to create different gingival conditions: gingival asymmetry, unilateral gingival recession, and bilateral gingival recession. These photographs were evaluated by 150 volunteers (19-70 years old) using a 100.0-mm visual analog scale. The volunteers consisted of 50 laypeople with no knowledge of dentistry, 50 general dentists, and 50 periodontists. Analysis of variance and Student t test were performed when data presented a normal distribution. If the hypothesis of normality was rejected, the Newman-Keuls test was applied to the data. Results showed that laypeople noticed gingival asymmetry only when it reached 2.0 mm, while periodontists and general dentists noticed it at 1.0 mm. Periodontists and general dentists considered smiles with unilateral recession of ≥1.0 mm to be less attractive, while the smallest modification that was deemed unesthetic by the laypeople was 2.0 mm. In the evaluation of bilateral gingival recession, general dentists and periodontists found smiles with a 1.0-mm modification less attractive, while the changes were not noticed by laypeople until the modification reached 1.5 mm. It can be concluded that laypeople perceived changes in smile esthetics differently than did dental professionals, which suggests that laypeople may be less concerned about the esthetic effects of minor gingival alterations than are dental professionals. Therefore, it is important for the dentist to understand the individual patient's perception of what constitutes an esthetic smile before recommending a dental treatment plan.
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Reed LI, Stratton R, Rambeas JD. Face Value and Cheap Talk: How Smiles Can Increase or Decrease the Credibility of Our Words. EVOLUTIONARY PSYCHOLOGY 2018; 16:1474704918814400. [PMID: 30497296 PMCID: PMC10480876 DOI: 10.1177/1474704918814400] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
How do our facial expressions affect the credibility of our words? We test whether smiles, either uninhibited or inhibited, affect the credibility of a written statement. Participants viewed a confederate partner displaying a neutral expression, non-Duchenne smile, Duchenne smile, or controlled smile, paired with a written statement. Participants then made a behavioral decision based on how credible they perceived the confederate's statement to be. Compared to a neutral expression, Experiment 1 found that participants were more likely to believe the confederate's statement when it was paired with a deliberate Duchenne smile and less likely to believe the confederate's statement when it was paired with a deliberate controlled smile. Experiment 2 replicated these findings with spontaneously emitted expressions. These findings provide evidence that uninhibited facial expressions can increase the credibility accompanying statements, while inhibited ones can decrease credibility.
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17
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Bolas-Colvee B, Tarazona B, Paredes-Gallardo V, Arias-De Luxan S. Relationship between perception of smile esthetics and orthodontic treatment in Spanish patients. PLoS One 2018; 13:e0201102. [PMID: 30102694 PMCID: PMC6089430 DOI: 10.1371/journal.pone.0201102] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022] Open
Abstract
One of the main objectives of orthodontic treatment is to achieve an esthetic smile. This study set out to analyze differences in the perception of smile esthetics among patients before and after receiving orthodontic treatment. 250 Spanish patients analyzed a single photograph in which, by means of computer software, midline diastema, black triangle, gingival margin of the left central incisor, and gingival ("gummy") smile were altered. Each patient analyzed these images before and after undergoing orthodontic treatment. Patients scored the photographs on a scale from 1 to 10. Statistical analyses of each group's level of perception were carried out, identifying significant differences in evaluations before and after treatment, and in relation to subjects' gender and age. Patients presented significant differences in the esthetic perception of midline diastema and gummy smile anomalies after they had completed orthodontic treatment. Gender influenced the perception of smile esthetics, whereby women were significantly more critical of midline diastema, black triangle and gingival margin of the upper central incisor than men. The age variable also showed significant differences in the perception of midline diastema and black triangle anomalies. The perception of smile esthetics of some dental anomalies changes as a result of orthodontic treatment. Gender influences the perception of some of the dental anomalies studied.
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18
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Chouvin M. [Not Available]. Orthod Fr 2018; 89:1. [PMID: 29676251 DOI: 10.1051/orthodfr/2018006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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19
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Lander K, Chuang L, Wickham L. Recognizing Face Identity from Natural and Morphed Smiles. Q J Exp Psychol (Hove) 2018; 59:801-8. [PMID: 16608747 DOI: 10.1080/17470210600576136] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
It is easier to identify a degraded familiar face when it is shown moving (smiling, talking; nonrigid motion), than when it is displayed as a static image (Knight & Johnston, 1997; Lander, Christie, & Bruce, 1999). Here we explore the theoretical underpinnings of the moving face recognition advantage. In Experiment 1 we show that the identification of personally familiar faces when shown naturally smiling is significantly better than when the person is shown artificially smiling (morphed motion), as a single static neutral image or as a single static smiling image. In Experiment 2 we demonstrate that speeding up the motion significantly impairs the recognition of identity from natural smiles, but has little effect on morphed smiles. We conclude that the recognition advantage for face motion does not reflect a general benefit for motion, but suggests that, for familiar faces, information about their characteristic motion is stored in memory.
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20
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Helwig NE, Sohre NE, Ruprecht MR, Guy SJ, Lyford-Pike S. Dynamic properties of successful smiles. PLoS One 2017; 12:e0179708. [PMID: 28658294 PMCID: PMC5489184 DOI: 10.1371/journal.pone.0179708] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 06/03/2017] [Indexed: 11/29/2022] Open
Abstract
Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile’s angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent. We define a “successful smile” as one that is rated effective, genuine, and pleasant in the colloquial sense of these words. We found that a successful smile can be expressed via a variety of different spatiotemporal trajectories, involving an intricate balance of mouth angle, smile extent, and dental show combined with dynamic symmetry. These findings have broad applications in a variety of areas, such as facial reanimation surgery, rehabilitation, computer graphics, and psychology.
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21
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Perron M, Roy-Charland A, Dickinson J, LaForge C, Ryan RJ, Pelot A. The use of the Duchenne marker and symmetry of the expression in the judgment of smiles in schizophrenia. Psychiatry Res 2017; 252:126-133. [PMID: 28260643 DOI: 10.1016/j.psychres.2017.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 11/17/2022]
Abstract
Research has recurrently shown that individuals with schizophrenia have impairments in emotional facial recognition and this deficit has been associated with aberrant visual scanning of the face. Because human beings have the ability to control the expression of emotion, the communication process becomes more complex. The goal of the current study was to conduct a systematic examination of the response pattern and perceptual-attentional processing in distinguishing smiles with the presence and absence of the Duchenne marker and symmetry and asymmetry of the activation in individuals with schizophrenia. Sixteen individuals diagnosed with schizophrenia and 16 control individuals were asked to judge whether the smiles were really happy or not. Individuals with schizophrenia produced fewer expected responses than controls in judging the symmetric non-Duchenne smile as not really happy. In addition, like their healthy counterparts, individuals with schizophrenia showed difficulty with the judgement of asymmetric Duchenne smiles. In addition to not being as sensitive to the cues, individuals with schizophrenia show differences in their viewing patterns. While the current study does not provide clear links between these viewing patterns and judgment responses, future research should explore other explanations, such as explicit knowledge, for the differences in results.
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22
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McDuff D, Kodra E, el Kaliouby R, LaFrance M. A large-scale analysis of sex differences in facial expressions. PLoS One 2017; 12:e0173942. [PMID: 28422963 PMCID: PMC5396880 DOI: 10.1371/journal.pone.0173942] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/01/2017] [Indexed: 11/23/2022] Open
Abstract
There exists a stereotype that women are more expressive than men; however, research has almost exclusively focused on a single facial behavior, smiling. A large-scale study examines whether women are consistently more expressive than men or whether the effects are dependent on the emotion expressed. Studies of gender differences in expressivity have been somewhat restricted to data collected in lab settings or which required labor-intensive manual coding. In the present study, we analyze gender differences in facial behaviors as over 2,000 viewers watch a set of video advertisements in their home environments. The facial responses were recorded using participants’ own webcams. Using a new automated facial coding technology we coded facial activity. We find that women are not universally more expressive across all facial actions. Nor are they more expressive in all positive valence actions and less expressive in all negative valence actions. It appears that generally women express actions more frequently than men, and in particular express more positive valence actions. However, expressiveness is not greater in women for all negative valence actions and is dependent on the discrete emotional state.
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23
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Oh SY, Bailenson J, Krämer N, Li B. Let the Avatar Brighten Your Smile: Effects of Enhancing Facial Expressions in Virtual Environments. PLoS One 2016; 11:e0161794. [PMID: 27603784 PMCID: PMC5014416 DOI: 10.1371/journal.pone.0161794] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/11/2016] [Indexed: 11/19/2022] Open
Abstract
Previous studies demonstrated the positive effects of smiling on interpersonal outcomes. The present research examined if enhancing one's smile in a virtual environment could lead to a more positive communication experience. In the current study, participants' facial expressions were tracked and mapped on a digital avatar during a real-time dyadic conversation. The avatar's smile was rendered such that it was either a slightly enhanced version or a veridical version of the participant's actual smile. Linguistic analyses using the Linguistic Inquiry Word Count (LIWC) revealed that participants who communicated with each other via avatars that exhibited enhanced smiles used more positive words to describe their interaction experience compared to those who communicated via avatars that displayed smiling behavior reflecting the participants' actual smiles. In addition, self-report measures showed that participants in the 'enhanced smile' condition felt more positive affect after the conversation and experienced stronger social presence compared to the 'normal smile' condition. These results are particularly striking when considering the fact that most participants (>90%) were unable to detect the smiling manipulation. This is the first study to demonstrate the positive effects of transforming unacquainted individuals' actual smiling behavior during a real-time avatar-networked conversation.
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24
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Helt MS, Fein DA. Facial Feedback and Social Input: Effects on Laughter and Enjoyment in Children with Autism Spectrum Disorders. J Autism Dev Disord 2016; 46:83-94. [PMID: 26254892 DOI: 10.1007/s10803-015-2545-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Both social input and facial feedback appear to be processed differently by individuals with autism spectrum disorder (ASD). We tested the effects of both of these types of input on laughter in children with ASD. Sensitivity to facial feedback was tested in 43 children with ASD, aged 8-14 years, and 43 typically developing children matched for mental age (6-14), in order to examine whether children with ASD use bodily feedback as an implicit source of information. Specifically, children were asked to view cartoons as they normally would (control condition), and while holding a pencil in their mouth forcing their smiling muscles into activation (feedback condition) while rating their enjoyment of the cartoons. The authors also explored the effects of social input in children with ASD by investigating whether the presence of a caregiver or friend (companion condition), or the presence of a laugh track superimposed upon the cartoon (laugh track condition) increased the children's self-rated enjoyment of cartoons or the amount of positive affect they displayed. Results showed that the group with ASD was less affected by all three experimental conditions, but also that group differences seemed to have been driven by one specific symptom of ASD: restricted range of affect. The strong relationship between restricted affect and insensitivity to facial feedback found in this study sheds light on the implications of restricted affect for social development in ASD.
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Peskin M, Newell FN. Familiarity Breeds Attraction: Effects of Exposure on the Attractiveness of Typical and Distinctive Faces. Perception 2016; 33:147-57. [PMID: 15109158 DOI: 10.1068/p5028] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Several studies have shown that facial attractiveness is positively correlated with both familiarity and typicality. Here we manipulated the familiarity of typical and distinctive faces to measure the effect on attractiveness. In our first experiment, we collected ratings of attractiveness, distinctiveness, and familiarity using three different groups of participants. Our stimuli included 84 images of female faces, presented in a full-face view. We replicated the finding that attractiveness ratings negatively correlate with distinctiveness ratings. In addition, we showed that attractiveness ratings were positively correlated with familiarity ratings. In our second experiment, we demonstrated that increasing exposure to faces increases their attractiveness, although there was no differential effect of exposure on typical and distinctive faces. Our results suggest that episodic familiarity affects attractiveness ratings independently of general or structural familiarity. The implications of our findings for the ‘face-space’ model are discussed.
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