Cognitive Bias Towards Face-related Information Among Groups With Maxillofacial Plastic Surgery

Individual's cognitive processing determines how an individual allocates and pays attention to the cognitive resources of body-related information in the external environment and shapes her/his behavior over time.A large number of studies have shown that adults who are not satisfied with their bodies have cognitive biases towards body-related information(such as body shape,food,etc.).Moreover,cognitive bias will further enhance the importance of relevant information and promote the development and maintenance of body dissatisfaction.According to Williamson,white,York Crowe and Stewart's(2004)the cognitive-behavioral theory,when body weight,body shape,food and other related information appear in the environment,it will automatically induce the activation of bodyschema,make the information with consistent schema more accessible,produce processing facilitation,and show attention,memory and interpretation bias in different processing stages.However,most of the researches in the field of negative physical self focus on the body image disorder or body dissatisfaction in fat dimension.At present,a small number of researches on the aspect dimensions of body image disorder are also concentrated in the non-clinical group of face dissatisfaction,and lack of research on the clinical group of face dissatisfaction.In this study,the facial attractiveness of the clinical patients with maxillofacial plastic surgery deviates from the public aesthetic standards to a large extent due to maxillofacial deformities,which may lead to some problems related to body image disorders such as facial appearance dissatisfaction.The research on face dissatisfaction of such cosmetic patients will help to expand the theory of body image disorder from fat dimension to facial appearance dimension,and expand the research object of facial appearance dimension from high-risk non-clinical group to clinical group;previous studies have found that body image plays an important role in the formation and development of individual physical and mental health and healthy personality.Therefore,it is necessary to explore the cognitive processing of face-related information of the patients with maxillofacial plastic surgery who are not satisfied with their facial appearance,and to examine the cognitive processing characteristics of such people.The aim of this research was to investigate the cognitive bias towards face-related information among groups with maxillofacial plastic surgery,including attention bias based on previous research,and focus on memory bias,and to provide abundant evidence for the study of the negative physical self.This research consisted of five studies.The first study used the dot-probe paradigm to examine the attention bias patterns of different words information related to facial appearance among groups with maxillofacial plastic surgery from the perspective of behavioral response.The results showed that compared with the control group,the patients with maxillofacial plastic surgery showed early vigilance to positive and negative face-related words,as well as late attention disengagement facilitation.In addition,the study also found that patients with maxillofacial plastic surgery showed attention avoidance of negative face-related words.According to all the indexes,the patients with maxillofacial plastic surgery showed the pattern of attention vigilance-avoidance to negative facerelated words.In Study 2,we explored the memory biases towards face-related words by visual attention shifting task(implicit learning)-recognition task among the patients with maxillofacial plastic surgery.The results showed that the correct recognition rate of negative face-related words was significantly higher in the group with maxillofacial plastic surgery than in the control group.In addition,the correct recognition rate of negative face-related words was significantly higher in the group with maxillofacial plastic surgery than in the positive face-related words and neutral words.The results showed that after implicit learning,the maxillofacial plastic surgery group had a memory bias to negative face-related words,but not to positive face-related words and non-face-related neutral words,which further indicated that in the visual attention shifting task,the group with maxillofacial plastic surgery will involuntarily invest more attention resources to negative face-related words so that the memory of this kind of information is better.In study 3,through the words learning and recognition task,we explored the memory bias characteristics towards the face-related words among the group with maxillofacial plastic surgery.The results showed that the recognition accuracy of positive face-related words in the maxillofacial plastic surgery group was significantly lower than that in the control group,while there was no significant difference in the recognition accuracy of negative face-related words between the two groups.However,on the other hand,it was found that the recognition accuracy of negative face-related words in the plastic surgery group was significantly higher than that of positive face-related words and neutral words.The results showed that through the explicit learning task,the maxillofacial plastic surgery group showed a memory bias for negative face-related words in the subsequent recognition test,but no memory bias for positive face-related words and neutral words.In addition,there was no significant difference in the recognition accuracy of the three types of words in the control group.In other words,although the results of this study did not find the differences in the ability of memory of negative facerelated words between groups,it was found that for the maxillofacial plastic surgery group,the information of extracting negative face-related words from explicit memory was more sensitive than that of extracting positive face-related words and neutral words.In study 4,visual attention shifting(implicit learning)-recognition task was used to explore the memory bias towards different attractive faces among the group with maxillofacial plastic surgery.The results showed that the recognition accuracy of high attractive faces was higher than that of low attractive faces.The results seemed to show that both the maxillofacial plastic surgery group and the control group have a memory bias towards highly attractive faces.That was to say,in the process of implicit learning task of visual attention shifting task,in the subconscious aspect,high attractive faces may attract more attention to subjects.In the early stage of visual attention shiting task,individuals allocate more cognitive resources to high attractive faces,which showed that in the later stage of recognition task,the memory accuracy of high attractive faces is higher,while that of the accuracy of low attractive faces was lower.Based on the face learning-recognition paradigm,study 5 used event-related potentials(ERPs)technology to investigate whether there was memory bias in the face image information processing among the maxillofacial plastic surgery group,and through the analysis of ERP components induced by high and low attractive face images,to provide electrophysiological evidence for in-depth revealing the dynamic changes of brain time course in the body self appearance dimension,which was helpful for better revealing the cognitive mechanism of face dissatisfaction in the patients with maxillofacial plastic surgery.The behavioral results showed that the marginal effect of face recognition in the maxillofacial plastic surgery group was significantly higher than that in the control group,which seemed to indicate that the plastic surgery group may have memory bias to the low attractive faces.ERP results showed that there were differences in the early processing patterns of high and low attractive faces between the two groups: compared with the control group,the N170 wave amplitude induced by low attractive faces was greater among the patients with maxillofacial plastic surgery,that is,the early processing of low attractive faces among the patients with maxillofacial plastic surgery will invest more attention resources;When recognizing low attractive faces,the patients induced a larger N250 wave amplitude than the control group,indicating that the patients had better recognition of low attractive faces.In the late processing,the LPC wave amplitude induced by the processing of high attractive faces among the patients with maxillofacial plastic surgery was significantly greater than that induced by low attractive faces,that is to say,the patients with maxillofacial plastic surgery may need more cognitive resources to extract high attractive faces from secondary memory.In sum,the results of this research partially supported the extension of the cognitive-behavioral theory of body image to the clinical group with maxillofacial plastic surgery.an individual's facial negative body self-schema will affect the process of attention,coding,organization,and recall of specific situation information and the patients will selectively pay attention to and remember the negative face-related words information consistent with the schema.However,the processing styles of low attractive faces for the clinical group with maxillofacial plastic surgery need further study.In this research,two paradigms of visual attention shifting-recognition task and learning-recognition task were used to explore the influence of the conscious and unconscious processing of stimulus materials(words and images)in the early stages of cognitive processing on subsequent recognition tasks.It was found that in study 2 and study 3,the clinical group with maxillofacial plastic surgery had a higher recognition accuracy of the negative face-related words.Study 4 did not find that the group with maxillofacial plastic surgery had better ability to remember low-attractive faces;study 5 found that the marginal effect of face recognition in the maxillofacial plastic surgery group was significantly higher than that in the control group,and induced greater N170 and N250.Based on the above results,it is preliminarily speculated that in conscious processing and unconscious processing,the clinical group with maxillofacial plastic surgery may be better than the control group in organizing the information related to negative facial appearance semantics.However,there is a difference in the ability of the group with maxillofacial plastic surgery to recognize the face images.This may be related to the stronger correlation between the face-related words information and the social stigmatization or teasing experience than the face images.The main significances and innovations of this research are as follows: firstly,theoretically,this study is an expansion of the existing research contents of the negative physical self.The existing western researches on body dissatisfaction mainly focus on the body weight(fat)dimension,while the researches on the facial appearance dimension are few and few kinds of research pay attention to the face dissatisfaction of clinical patients;Moreover,it is of great significance to verify whether the findings of the fat dimension that has been relatively mature in the negative physical self domain can be extended to the facial appearance dimension.Although Feragen and Stock(2018)based on the cognitive-behavior model proposed by Cash(2012)summarized the influencing factors of body image of maxillofacial deformities,this study for the first time experimentally verified the applicability of body-schema in the cognitive-behavior model for groups with maxillofacial plastic surgery.Secondly,in terms of application,this study mainly discusses the cognitive processing process of face-related information of patients with maxillofacial plastic surgery before surgery,which can provide some support for the intervention model annotation in the field of the negative physical self.