The relationship between facial skeletal class and expert-rated interpersonal skill: an epidemiological survey on young Italian adults

BMC Psychiatry BioMed Central Research article Open Access The relationship between facial skeletal class and expert-rated interpersonal skill: an epidemiological survey on young Italian adults Andrea Senna*1,2, Domenico Abbenante3, Lucio Tremolizzo4, Guglielmo Campus5 and Laura Strohmenger1,2 Address: 1Dept. of Medicine, Surgery and Dentistry, University of Milano; Dental Building, Via Beldiletto, 1 – 20124 Milano, Italy, 2WHO Collaborating Centre for Epidemiology and Community Dentistry of Milano, Italy, 3Guidonia Aeromedical Selection Centre, (RM), Italy, 4D.N.T.B., University of Milano-Bicocca, Monza (MI), Italy and 5Dental Institute, University of Sassari, Italy Email: Andrea Senna* - ; Domenico Abbenante - ; Lucio Tremolizzo - ; Guglielmo Campus - ; Laura Strohmenger - * Corresponding author Published: 10 October 2006 BMC Psychiatry 2006, 6:41 doi:10.1186/1471-244X-6-41 Received: 22 March 2006 Accepted: 10 October 2006 This article is available from: http://www.biomedcentral.com/1471-244X/6/41 © 2006 Senna et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: The facial region plays a major role in determining physical attractiveness, so we assessed the hypothesis that the capability of successfully managing interpersonal relationships in young adults might be related to the facial skeletal class. Methods: 1,014 young subjects applying to the Military Academy of Pozzuoli, Italy, were enrolled and the cephalometric evaluation was performed by calculating the angular relationships between skeletal points localized by the lateral cephalogram of the face, sorting the subjects in three groups corresponding to each major facial skeletal class. Concurrently, the subjects were evaluated by a team of psychiatrists administering the MMPI-2 test followed by a brief colloquium with each candidate, in order to identify those subjects characterized by low skills for managing interpersonal relationships. Results: According to the psychiatric evaluation about 20% of the subjects were considered potentially unable to manage successfully interpersonal relationships (NS). Males displayed an about two-fold increased risk of being NS. No differences were shown in the distribution of the NS male subjects among the three different facial skeletal classes. On the other hand, NS females displayed a different distribution among the three facial skeletal classes, with a trend of about two-fold and four-fold, respectively, for those subjects belonging to classes II and III, respect to those belonging to class I. Conclusion: Females may be more sensitive to physical factors determining beauty, such as the facial morphology certainly is. This finding appears to be interesting especially when thinking about possible orthodontic interventions, although further study is certainly needed to confirm these results. Background Physical attractiveness has been shown to play a major role in determining both one person's self-esteem and his/ her capability of successfully managing social relation- Page 1 of 6 (page number not for citation purposes) BMC Psychiatry 2006, 6:41 ships (Patzer 1996; Dion et al. 1972; Miller 1970; Berscheid and Walster 1972). Moreover, attractive individuals are more frequently regarded as desirable friends and they are considered to be socially skilled. Interestingly, in a study conducted by Efran (1974), attractive individuals were more easily judged as less guilty in a simulated jury task, and less severe punishment were recommended. The influence of dento-facial appearance on social attractiveness has been extensively studied. For example, Shaw and colleagues, among others, clearly demonstrated that dental arrangement plays a major role in determining the perceived beauty and success of one person (Shaw et al. 1985; Shaw et al. 1980; Shaw 1981; Kerosuo et al. 1995; Sergl and Stodt 1970). However, it is conceivable that the facial skeletal structure has a greater esthetic and physiologic impact on one subject than dental morphology alone (Jefferson 1996). As a matter of fact, Michiels and Sather (1994) previously reported that a sample of white women was judged as less attractive if displaying increased vertical features, or convex, or facial class II tendency profiles. Therefore, our aim in this study was to investigate if a particular facial skeletal class was somehow related to the capacity of successfully managing interpersonal relationships in a population of young Italian adults, since both parameters have been shown to be related to the perceived beauty. Possibly this study might help to better understand the determinants of attractiveness, resulting useful when planning specific orthodontic and/or facial surgery interventions. Methods 1,014 consecutive subjects (M/F: 776/248; mean age ± SD: 19.8 ± 2.5 y.o.) applying to the military academy of Pozzuoli, Italy, were enrolled following explanation of the aims of the study and obtaining informed consent. Each candidate underwent to a complete dental evaluation by two dentists, trained in the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan, Italy. No one of the enrolled subjects underwent to a previous maxillo-facial surgical intervention. The skeletal class determination was performed by calculating the angular relationship between nasion (N), sellion (S), and Down's points A and B, obtained from the lateral cephalogram (Figure 1A). Subsequently, the skeletal classes were defined on the basis of the ANB angle as follows: ANB = 2 ± 2, I class; ANB > 4, II class; ANB < 0, III class (Morabito et al. 1982; for a representation of the three facial skeletal classes see Figure 1B to 1D). http://www.biomedcentral.com/1471-244X/6/41 requisite for the admission to a stressful environment, such as the Military Academy, was performed by a team of board-qualified psychiatrists. It is well known that for various reasons, individuals undergoing a psychological assessment may over-report or underreport problems. Moreover, as the stakes involved in a psychological evaluation increase, so does the likelihood that the individual will distort his or her responses (Sellbom et al. 2005). Hence, the military academy of Pozzuoli, Italy, requires every candidate to be evaluated by self-administering a standardized personality test, the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Sellbom et al. 2005), followed by a brief colloquium with the team of boardqualified psychiatrists, in order to confirm the orientation given by the test. According to the psychiatric evaluation each subject was judged either as potentially either successful (S), or not-successful (NS) in managing interpersonal relationships. Statistical ana (...truncated)