How the Experience of Emotion is Modulated by Facial Feedback

Revealed masks: Facial mimicry after oxytocin administration in forensic psychopathic patients

Facial mimicry serves as an evolutionarily rooted important interpersonal communication process that touches on the concepts of socialization and empathy. Facial electromyography (EMG) of the corrugator muscle and the zygomaticus muscle was recorded while male forensic psychopathic patients and controls watched morphed angry or happy facial expressions. We tested the hypothesis that psychopathic patients would show weaker short latency facial mimicry (that is, within 600 ms after stimulus onset) than controls. Exclusively in the group of 20 psychopathic patients, we tested in a placebo-controlled crossover within-subject design the hypothesis that oxytocin would enhance short-latency facial mimicry. Compared with placebo, we found no oxytocin-related significant short-latency responses of the corrugator and the zygomaticus. However, compared with 19 normal controls, psychopathic patients in the placebo condition showed significantly weaker short-latency zygomaticus responses to happy faces, while there was a trend toward significantly weaker short-latency corrugator responses to angry faces. These results are consistent with a recent study of facial EMG responses in adolescents with psychopathic traits. We therefore posit a lifetime developmental deficit in psychopathy pertaining short-latency mimicry of emotional facial expressions. Ultimately, this deficit in mimicking angry and happy expressions may hinder the elicitation of empathy, which is known to be impaired in psychopathy.

Psychosocial functioning in patients with altered facial expression: a scoping review in five neurological diseases

PURPOSE

To perform a scoping review to investigate the psychosocial impact of having an altered facial expression in five neurological diseases.

METHODS

A systematic literature search was performed. Studies were on Bell's palsy, facioscapulohumeral muscular dystrophy (FSHD), Moebius syndrome, myotonic dystrophy type 1, or Parkinson's disease patients; had a focus on altered facial expression; and had any form of psychosocial outcome measure. Data extraction focused on psychosocial outcomes.

RESULTS

Bell's palsy, myotonic dystrophy type 1, and Parkinson's disease patients more often experienced some degree of psychosocial distress than healthy controls. In FSHD, facial weakness negatively influenced communication and was experienced as a burden. The psychosocial distress applied especially to women (Bell's palsy and Parkinson's disease), and patients with more severely altered facial expression (Bell's palsy), but not for Moebius syndrome patients. Furthermore, Parkinson's disease patients with more pronounced hypomimia were perceived more negatively by observers. Various strategies were reported to compensate for altered facial expression.

CONCLUSIONS

This review showed that patients with altered facial expression in four of five included neurological diseases had reduced psychosocial functioning. Future research recommendations include studies on observers' judgements of patients during social interactions and on the effectiveness of compensation strategies in enhancing psychosocial functioning.

Consensus Among International Facial Therapy Experts for the Management of Adults with Unilateral Facial Palsy: A Two-Stage Nominal Group and Delphi Study

Background: Nonsurgical rehabilitation of unilateral peripheral facial palsy (FP) varies globally with controversy regarding best practice. Objective: To develop facial therapist consensus regarding what should be included or excluded in rehabilitation of adults with FP of any etiology. Three clinical presentations: flaccid, paretic and synkinetic, were separately considered. Methodology: A two-stage study was conducted: a nominal group technique (NGT) to develop a questionnaire plus Delphi study. Delphi participants were recruited worldwide, through an experience-based inclusion questionnaire. The final Delphi questionnaire included 166 items for each clinical presentation covering assessment, outcome measures, and interventions, for example, education, eye care, neuromuscular retraining, and electrical modalities. Inclusion/exclusion agreement was set at 80%, indicating participant consensus. Items reaching 70-79% were deemed "near-included/near-excluded." Results: Averaged across all presentations, 24.9% of the 166 items were included, (e.g., Sunnybrook Facial Grading System, patient education and neuromuscular retraining), 26.9% of the 166 items were excluded, (e.g., gross strengthening and electrical stimulation); 48.2% were neither included nor excluded. Conclusion: This study brings together the global community's expertise as a first step toward establishing best practice for specialist facial therapy. It is hoped this will guide clinical decision making, advance research, and optimize patient outcomes in this challenging field.

Sensorimotor regulation of facial expression - An untouched frontier

Facial expression is a critical form of nonverbal social communication which promotes emotional exchange and affiliation among humans. Facial expressions are generated via precise contraction of the facial muscles, guided by sensory feedback. While the neural pathways underlying facial motor control are well characterized in humans and primates, it remains unknown how tactile and proprioceptive information reaches these pathways to guide facial muscle contraction. Thus, despite the importance of facial expressions for social functioning, little is known about how they are generated as a unique sensorimotor behavior. In this review, we highlight current knowledge about sensory feedback from the face and how it is distinct from other body regions. We describe connectivity between the facial sensory and motor brain systems, and call attention to the other brain systems which influence facial expression behavior, including vision, gustation, emotion, and interoception. Finally, we petition for more research on the sensory basis of facial expressions, asserting that incomplete understanding of sensorimotor mechanisms is a barrier to addressing atypical facial expressivity in clinical populations.

Inability to move one's face dampens facial expression perception

Humans rely heavily on facial expressions for social communication to convey their thoughts and emotions and to understand them in others. One prominent but controversial view is that humans learn to recognize the significance of facial expressions by mimicking the expressions of others. This view predicts that an inability to make facial expressions (e.g., facial paralysis) would result in reduced perceptual sensitivity to others' facial expressions. To test this hypothesis, we developed a diverse battery of sensitive emotion recognition tasks to characterize expression perception in individuals with Moebius Syndrome (MBS), a congenital neurological disorder that causes facial palsy. Using computer-based detection tasks we systematically assessed expression perception thresholds for static and dynamic face and body expressions. We found that while MBS individuals were able to perform challenging perceptual control tasks and body expression tasks, they were less efficient at extracting emotion from facial expressions, compared to matched controls. Exploratory analyses of fMRI data from a small group of MBS participants suggested potentially reduced engagement of the amygdala in MBS participants during expression processing relative to matched controls. Collectively, these results suggest a role for facial mimicry and consequent facial feedback and motor experience in the perception of others' facial expressions.

Why We Gather: A New Look, Empirically Documented, at Émile Durkheim's Theory of Collective Assemblies and Collective Effervescence

For Durkheim, individuals' survival and well-being rest on cultural resources and social belonging that must be revived periodically in collective assemblies. Durkheim's concern was to clarify how these assemblies achieve this revitalization. An intensive examination of primitive religions led him to identify successive levels of engagement experienced by participants and to develop explanatory principles relevant to all types of collective gatherings. Durkheim's conception is widely referred to nowadays. However, the question of its empirical status remains open. We extracted from his text his main statements and translated them into research questions. We then examined each question in relation to current theories and findings. In particular, we relied on the plethora of recent cognitive and social-psychology studies that document conditions of reduced self-other differentiation. Abundant data support that each successive moment of collective assemblies contributes to blurring this differentiation. Ample support also exists that because shared emotions are increasingly amplified in collective context, they can fuel high-intensity experiences. Moreover, recent studies of self-transcendent emotions can account for the self-transformative effects described by Durkheim at the climax of collective assemblies. In conclusion, this century-old model is remarkably supported by recent results, mostly collected in experimental settings.

"When You're Smiling": How Posed Facial Expressions Affect Visual Recognition of Emotions

Facial imitation occurs automatically during the perception of an emotional facial expression, and preventing it may interfere with the accuracy of emotion recognition. In the present fMRI study, we evaluated the effect of posing a facial expression on the recognition of ambiguous facial expressions. Since facial activity is affected by various factors, such as empathic aptitudes, the Interpersonal Reactivity Index (IRI) questionnaire was administered and scores were correlated with brain activity. Twenty-six healthy female subjects took part in the experiment. The volunteers were asked to pose a facial expression (happy, disgusted, neutral), then to watch an ambiguous emotional face, finally to indicate whether the emotion perceived was happiness or disgust. As stimuli, blends of happy and disgusted faces were used. Behavioral results showed that posing an emotional face increased the percentage of congruence with the perceived emotion. When participants posed a facial expression and perceived a non-congruent emotion, a neural network comprising bilateral anterior insula was activated. Brain activity was also correlated with empathic traits, particularly with empathic concern, fantasy and personal distress. Our findings support the idea that facial mimicry plays a crucial role in identifying emotions, and that empathic emotional abilities can modulate the brain circuits involved in this process.

An Audience Facilitates Facial Feedback: A Social-Context Hypothesis Reconciling Original Study and Nonreplication

Nonreplications of previously undisputed phenomena tend to leave a theoretical vacuum. This theoretical perspective seeks to fill the gap left by the failure to replicate unobtrusive facial feedback. In the emblematic original study, participants who held a pen between the teeth (i.e., requiring activity of the zygomaticus major muscle) rated cartoons more positively than participants who held the pen between the lips. We argue that the same social mechanisms (e.g., the presence of an audience) modulate facial feedback to emotion as are involved in the feed-forward shaping of facial actions by emotions. Differing social contexts could thus help explain the contrast between original findings and failures to obtain unobtrusive facial feedback. An exploratory analysis that included results only from (unobtrusive) facial-feedback studies without explicit reference to emotion in the facial manipulation provided preliminary support for this hypothesis. Studies with a social context (e.g., due to experimenter presence) showed a medium-sized aggregate facial-feedback effect, whereas studies without a social context (e.g., when facial actions were only filmed), revealed a small effect. Video awareness strengthened facial feedback considerably within an engaging social context, but seemed to reduce it without a social context. We provisionally conclude that a (pro-)social interpretation of facial actions facilitates feedback to (primarily positive) emotion, and suggest further research explicitly manipulating this context.

The association of negative mood with automatic and effortful facial expression mimicry

The natural process of mimicking the facial expressions of others is well established, as are the deficits in this reflexive behavior for individuals with clinical disorders such as depression. This study examines the extent of this deficit in non-clinical individuals with high transient negative mood, and whether it extends to both automatic and effortful emotion expression behavior. One hundred and thirty-six participants were shown happy, sad, and neutral faces, while electromyography (EMG) recorded facial muscle responses. Automatic (reflexive) mimicry was assessed while participants simply viewed facially expressive photographs, while effortful mimicry was monitored when individuals were told to intentionally copy the expressions in the photographs. Results indicated that high levels of negative mood were primarily associated with deficits in effortful mimicry of happy expressions, although some similar evidence was found in automatic mimicry of happy faces. Surprisingly, there were also ties between negative moods and inaccuracies in effortful mimicry of sad expressions (but not automatic mimicry). Inaccurate automatic and effortful mimicry were also tied with lower self-reported social support and greater loneliness. These results indicate that even in healthy individuals, transient and minor changes in negative mood are tied to deficiencies in facial mimicry at both the automatic and effortful level.

Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta-Analysis

BACKGROUND

Depression is a leading cause of disability worldwide. Preliminary evidence suggests that glabellar onabotulinumtoxinA injections improve depression scores with few side effects compared to current first-line antidepressant medications. The authors' review reports on these studies, hypothesizing that glabellar onabotulinumtoxinA injections can be an alternative safe and effective treatment for depression.

METHODS

A systematic review and meta-analysis of the relevant literature was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Cochrane Library, Embase, and Scopus databases were searched in August of 2020 using the keywords ["botox" OR "botulinum"] AND ["mood" OR "depression"] for articles published between 1980 and 2020. Prospective studies and randomized controlled trials on the use of glabellar onabotulinumtoxinA injections for the primary purpose of treating depression were considered. The primary endpoint for the meta-analysis was the mean difference in primary depression scores after treatment, along with a second endpoint of the standardized mean difference in depression scores among treated patients including all nine studies.

RESULTS

Of the 499 reviewed articles, nine studies were included that reported improvement in mean depression scores from baseline. All five randomized controlled trials reported an improvement in mean depression scores at 6 weeks after treatment, with a weighted average change of -8.39 points ( p < 0.0001). The aggregate standardized mean difference from baseline to the primary endpoint across all nine prospective studies was -1.61 SD ( p < 0.0001).

CONCLUSION

Meta-analysis and systematic review of the included studies provide support for an antidepressant effect of glabellar onabotulinumtoxinA injections.

Unzipping empathy in psychopathy: Empathy and facial affect processing in psychopaths

Psychopathy is a neurodevelopmental disorder that has a highly deleterious effect upon both individuals and society at large. Psychopaths grossly neglect and disrespect the interests of others. Their antisocial behavior is thought to originate from a lack of empathy. However, empathy is multidimensional in nature, as evidenced by the considerable heterogeneity in extant theorizing on the subject. Here, we present the "Zipper model of empathy" that reconsiders how both its affective and cognitive components converge in mature empathic behavior. Furthermore, the Zipper model of empathy is expedient for explaining the empathy deficits in psychopathy, insofar as it brings together current theories on the dysfunctional affective components of empathy, violence inhibition, and automatic versus goal-directed attention. According to the literature, the neurobiological underpinnings of these theories are amygdala-centered; however, this article traces this specifically to the basolateral and central amygdala subregions. When viewed together, the cognitive and affective components of empathy are zipped together in a natural fashion in healthy empathic behavior, whereas psychopaths leave the zipper substantially unzipped in pursuit of their purely self-centered goals.

Cognitive Performance After Facial Botulinum Toxin Treatment in a Cohort of Neurologic Patients: An Exploratory Study

OBJECTIVE

To investigate higher cognitive functions after mimicry changes after facial botulinum toxin (BTX) injections, we tested verbal and nonverbal reasoning in patients with blepharospasm or hemifacial spasm before and after their long-term botulinum toxin treatment.

DESIGN

Explorative, nonrandomized, clinical trial.

SETTING

Patients receiving ambulatory care and control participants from the general community.

PARTICIPANTS

Volunteer sample (N=84) of patients (n=21) with blepharospasm or hemifacial spasm who received facial BTX injections. Control participants included patients (n=30) with cervical dystonia who received cervical BTX injections and individuals without neurological disorders (n=33).

INTERVENTIONS

The 2 groups receiving injections were tested before and 3 weeks after their treatment. The group without neurological disorders received no injections.

MAIN OUTCOME MEASURES

Verbal and nonverbal reasoning scores.

RESULTS

The key unexpected finding was that patients who received facial BTX injections perform significantly worse in nonverbal reasoning tasks, when compared with those who did not receive injections (P=.022). There was no significant difference in the baseline reasoning scores and at follow-up for verbal reasoning between the 3 groups. There was no correlation between toxin dose and reasoning scores (verbal: P=.132; nonverbal: P=.294).

CONCLUSIONS

Because of potential confounders, the results do not yet allow any conclusion on causality. Further research is needed to confirm our findings.

Effects of posed smiling on memory for happy and sad facial expressions

The perception and storage of facial emotional expressions constitutes an important human skill that is essential for our daily social interactions. While previous research revealed that facial feedback can influence the perception of facial emotional expressions, it is unclear whether facial feedback also plays a role in memory processes of facial emotional expressions. In the present study we investigated the impact of facial feedback on the performance in emotional visual working memory (WM). For this purpose, 37 participants underwent a classical facial feedback manipulation (FFM) (holding a pen with the teeth—inducing a smiling expression vs. holding a pen with the non-dominant hand—as a control condition) while they performed a WM task on varying intensities of happy or sad facial expressions. Results show that the smiling manipulation improved memory performance selectively for happy faces, especially for highly ambiguous facial expressions. Furthermore, we found that in addition to an overall negative bias specifically for happy faces (i.e. happy faces are remembered as more negative than they initially were), FFM induced a positivity bias when memorizing emotional facial information (i.e. faces were remembered as being more positive than they actually were). Finally, our data demonstrate that men were affected more by FFM: during induced smiling men showed a larger positive bias than women did. These data demonstrate that facial feedback not only influences our perception but also systematically alters our memory of facial emotional expressions.

Facial Muscles Reactions to Other Person’s Facial Expressions of Pain

The aim of this study was to record facial electromiograms (EMG) while subjects were viewing facial expressions of different pain levels (no-pain, medium pain and very painful) and to find objective criteria for measuring pain expressed in human’s face. The study involved 18 students with age 21 years. The magnitude of the EMG response of m. corrugator supercilii depended on voluntary performed facial pain expression in the subjects. EMG responses of voluntary performed facial pain expressions to mirrored pain reactions were detected at two time span intervals: 200–300 ms after stimulation in m. zygomaticus major, and 400–500 ms after stimulation in m. corrugator supercilii. These differences disappear after 1300 ms. In the second time interval, differences in EMG responses of both muscle groups occur 1600 ms after stimulus presentation, but disappear differently: 3100 ms after stimulation in m. zygomaticus major and 4000 ms in m. corrugator supercilii. Constant responding with “medium pain” expression when recognizing faces of different pain expressions have an effect on the voluntary EMG responses of individual subjects. Images with emotional expression “no pain” reduce m. corrugator supercilii activity and increase m. zygomaticus major activity for those observers.

Organizational and Human Factors Affecting Forensic Decision-Making: Workplace Stress and Feedback

Although forensic examiners operate in a stressful environment, there is a lack of understanding about workplace stress and feedback. These organizational and human factors can potentially impact forensic science judgments. In this study, 150 practicing forensic examiners from one laboratory were surveyed about their experiences of workplace stress, and the explicit and implicit feedback they receive. Forensic examiners reported that their high stress levels originated more from workplace-related factors (management and/or supervision, backlogs, and the pressure to do many cases) than from personal related factors (family, medical, and/or financial). The findings showed that a few (8%) of the forensic examiners sometimes felt strong implicit feedback about what conclusions were expected from them and that some (14%) also strongly felt that they were more appreciated when they helped to solve a case (e.g., by reaching a "match" as opposed to an "inconclusive" conclusion). Differences were found when comparing workplace stress and feedback levels across three core forensic science fields (forensic biology, chemistry, and latent prints) and across career stages (early, mid, and late). Gaining insights into the stress factors within a workplace and explicit and implicit feedback has implications for developing policies to improve the well-being, motivation, and performance of forensic examiners.

Are Positive Interventions Always Beneficial?

Can people improve their lives by smiling more, trying to have a better posture, and by thinking about good memories? Can individuals become more successful by deliberatively engaging in positive actions and thoughts? Do people feel better by following recommendations from naïve psychology? In the present article we discuss these questions, noting that although some popular interventions thought to be universally beneficial (e.g., inductions of happiness, self-affirmation, empowerment, self-distancing) can sometimes yield positive outcomes, at other times the outcomes can also be negative. Taking an empirical approach based on experimental evidence, we postulate that understanding the underlying processes discovered in the science of persuasion is the key for specifying why, when, and for whom these practical initiatives are more likely to work or to backfire.

[Modern views on the relationship between psychoemotional state and the bioelectrical activity of facial muscles]

The paper presents a review of the literature data reflecting the relevance and current views on the problem of facial feedback. It considers the relationship between the bioelectric activity of facial muscles and neuropsychic stress. The modern issues dedicated to the study of the correlation between the indicators assessing the tonic activity of facial muscles and psycho-emotional stress are highlighted. Particular emphasis is placed on the scientific concept of emotional proprioception, according to which facial muscle activity through the trigeminal and facial nerves affects the emotional centers of the brain, by improving or worsening the emotional state. The currently known methods for the correction of psychoemotional states, which are based on the feedback mechanism, are analyzed. The possibilities of using neuromuscular relaxation of the facial muscles to correct psychoemotional conditions are considered.

The ethics of positive thinking in healthcare

In continuation with the New Thought movement that arose in the United States in the 19th Century, there is now a massive self-help industry that markets books and seminars. This industry has also extended to healthcare in the form of positive thinking, i.e., the idea that happy thoughts are essential for health. While some of these claims may seem reasonable and commonsensical, they are not free of problems. This article posits that positive thinking has some ethical underpinnings. Extreme positive thinking may promote alternative forms of medicine that ultimately substitute effective treatment, and this is unethical. The emphasis on positive thinking for cancer patients may be too burdensome for them. Likewise, unrestricted positive thinking is not necessarily good for mental health. After considering the ethics of positive thinking, this article proposes a more realistic approach.

Mimicking and sharing emotions: a re-examination of the link between facial mimicry and emotional contagion

Facial mimicry has long been considered a main mechanism underlying emotional contagion (i.e. the transfer of emotions between people). A closer look at the empirical evidence, however, reveals that although these two phenomena often co-occur, the changes in emotional expressions may not necessarily be causally linked to the changes in subjective emotional experience. Here, we directly investigate this link, by testing a model in which facial activity served as a mediator between the observed emotional displays and subsequently felt emotions (i.e. emotional contagion). Participants watched videos of different senders displaying happiness, anger, or sadness, while their facial activity was recorded. After each video, participants rated their own emotions and assessed the senders' likeability and competence. Participants both mimicked and reported feeling the emotions displayed by the senders. Moreover, their facial activity partially explained the association between the senders' emotional displays and self-reported emotions, thereby supporting the notion that facial mimicry may be involved in emotional contagion.

Coding valence in touchscreen interactions: hand dominance and lateral movement influence valence appraisals of emotional pictures

The Body-Specificity Hypothesis postulates that the space surrounding the dominant hand is perceived as positive due to the motor fluency of this hand, whereas the space surrounding the non-dominant hand is perceived as negative. Experimental studies based on this theoretical framework also revealed associations between affective valence and hand dominance (i.e., dominant hand-positive; non-dominant hand-negative), or lateral movements of the hands (i.e., right hand toward the right space-positive; left hand toward the left space-positive). Interestingly, these associations have not been examined with regard to how lateral actions of the hands may influence affective experiences as, for example, in valence appraisals of affective objects that have been manipulated. The study presented here has considered this question in light of the emerging interest of embodied cognition approaches to interactive technologies, particularly in affective experiences with touchscreen interfaces. Accordingly, right-handed participants evaluated the valence of positive and negative emotional pictures after interacting with them either with the dominant right or with the non-dominant left hand. Specifically, they moved the pictures either from left to right or from right to left sides of a touchscreen monitor. The results indicated that a valence matching between the hand used for the interactions, the picture's valence category, and the movement's starting side reinforced the valence appraisals of the pictures (i.e., positive/negative pictures were more positively/negatively evaluated). The findings are discussed against the background of the Theory of Event Coding, which accounts for both the affective properties of the stimuli and the affective connotation of the related action.