Frontiers in public health · 2026
Social appearance anxiety and aggressive behavior in children with dentofacial deformities: a mediation and profile analysis of family support and self-stigma.
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Wang Wenjun, Zhang Jingjing, Xia Bin, Zhu Junxia
Аннотация
OBJECTIVE: To examine the relationship between social appearance anxiety and aggressive behavior in children with dentofacial deformities, to investigate the mediating role of self-stigma and the moderating role of family support within this relationship, and to identify heterogeneous subgroups of social appearance anxiety and self-stigma through a person-centered approach.
METHODS: A cross-sectional survey design was employed. A total of 482 children diagnosed with dentofacial deformities were recruited from Peking University School and Hospital of Stomatology between September 2025 and March 2026. Participants completed validated Chinese versions of the Social Appearance Anxiety Scale, the Self-Stigma subscale, the Family Support subscale, and the Aggression Scale.
RESULTS: Social appearance anxiety was significantly and positively associated with aggressive behavior (B = 0.129, p = 0.007). Self-stigma showed a significant indirect statistical association between social appearance anxiety and aggressive behavior [indirect effect = 0.352, 95% CI (0.233, 0.482)]. Family support was a significant statistical moderator of both the direct and indirect pathways: the cross-sectional direct effect of social appearance anxiety on aggressive behavior was attenuated and became non-significant at high levels of family support, and the index of moderated mediation was significant [-0.020, 95% bootstrap CI (-0.038, -0.005)], indicating that higher family support weakened the cross-sectional indirect effect transmitted through self-stigma. LPA identified three distinct latent profiles: a low social appearance anxiety-self-stigma group (51.8%), a moderate social appearance anxiety-self-stigma group (36.5%), and a high social appearance anxiety-self-stigma group (11.7%). The three profiles differed significantly in both aggressive behavior (F = 113.374, p < 0.001) and family support (F = 3.480, p = 0.032), with the high-profile group exhibiting the most elevated levels of aggressive behavior.
CONCLUSION: These findings highlight the imperative of integrating psychological assessment and family-centered intervention into the clinical care of children with dentofacial deformities.
METHODS: A cross-sectional survey design was employed. A total of 482 children diagnosed with dentofacial deformities were recruited from Peking University School and Hospital of Stomatology between September 2025 and March 2026. Participants completed validated Chinese versions of the Social Appearance Anxiety Scale, the Self-Stigma subscale, the Family Support subscale, and the Aggression Scale.
RESULTS: Social appearance anxiety was significantly and positively associated with aggressive behavior (B = 0.129, p = 0.007). Self-stigma showed a significant indirect statistical association between social appearance anxiety and aggressive behavior [indirect effect = 0.352, 95% CI (0.233, 0.482)]. Family support was a significant statistical moderator of both the direct and indirect pathways: the cross-sectional direct effect of social appearance anxiety on aggressive behavior was attenuated and became non-significant at high levels of family support, and the index of moderated mediation was significant [-0.020, 95% bootstrap CI (-0.038, -0.005)], indicating that higher family support weakened the cross-sectional indirect effect transmitted through self-stigma. LPA identified three distinct latent profiles: a low social appearance anxiety-self-stigma group (51.8%), a moderate social appearance anxiety-self-stigma group (36.5%), and a high social appearance anxiety-self-stigma group (11.7%). The three profiles differed significantly in both aggressive behavior (F = 113.374, p < 0.001) and family support (F = 3.480, p = 0.032), with the high-profile group exhibiting the most elevated levels of aggressive behavior.
CONCLUSION: These findings highlight the imperative of integrating psychological assessment and family-centered intervention into the clinical care of children with dentofacial deformities.