Interesting that there are so many similarities between how people describe the distortions and fantasy creatures like orcs, vampires, etc. It makes me wonder how much our own fiction influences these peoples' conditions, or in reverse how people with conditions such as these have influenced our fiction.
Realistically, the simple answer is that it's probably not much of either; There's a "built-in" concept of what is scary in terms of physical features that has an evolutionary benefit in keeping us safe from certain animals that we can easily transpose onto humans, and that system is being tapped into in some form for these people in the routine processing of faces.
Realistically, the simple answer is that it's probably not much of either; There's a "built-in" concept of what is scary in terms of physical features that has an evolutionary benefit in keeping us safe from certain animals that we can easily transpose onto humans, and that system is being tapped into in some form for these people in the routine processing of faces.