1
|
Heilman KM. Disorders of facial emotional expression and comprehension. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:99-108. [PMID: 34389127 DOI: 10.1016/b978-0-12-822290-4.00006-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One of the most important means of communicating emotions is by facial expressions. About 30-40 years ago, several studies examined patients with right and left hemisphere strokes for deficits in expressing and comprehending emotional facial expressions. The participants with right- or left-hemispheric strokes attempted to determine if two different actors were displaying the same or different emotions, to name the different emotions being displayed, and to select the face displaying an emotion named by the examiner. Investigators found that the right hemisphere-damaged group was impaired on all these emotional facial tests and that this deficit was not solely related to visuoperceptual processing defects. Further studies revealed that the patients who were impaired at recognizing emotional facial expressions and who had lost these visual representations of emotional faces often had damage to their right parietal lobe and their right somatosensory cortex. Injury to the cerebellum has been reported to impair emotional facial recognition, as have dementing diseases such as Alzheimer's disease and frontotemporal dementia, movement disorders such as Parkinson's disease and Huntington's disease, traumatic brain injuries, and temporal lobe epilepsy. Patients with right hemisphere injury are also more impaired than left-hemisphere-damaged patients when attempting to voluntarily produce facial emotional expressions and in their spontaneous expression of emotions in response to stimuli. This impairment does not appear to be induced by emotional conceptual deficits or an inability to experience emotions. Many of the disorders that cause impairments of comprehension of affective facial expressions also impair facial emotional expression. Treating the underlying disease may help patients with impairments of facial emotion recognition and expression, but unfortunately, there have not been many studies of rehabilitation.
Collapse
Affiliation(s)
- Kenneth M Heilman
- Department of Neurology, University of Florida College of Medicine and Geriatric Research, Education, and Clinical Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, United States.
| |
Collapse
|
2
|
McDonald S, Genova H. The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:235-260. [PMID: 34389120 DOI: 10.1016/b978-0-12-822290-4.00011-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This chapter provides a review of the emotional and psychosocial consequences of moderate to severe traumatic brain injury (TBI). Many of the disorders affecting socioemotional function arise from damage to frontotemporal systems, exacerbated by white matter injury. They include disorders of social cognition, such as the ability to recognize emotions in others, the ability to attribute mental states to others, and the ability to experience empathy. Patients with TBI also often have disorders of emotion regulation. Disorders of drive or apathy can manifest across cognitive, emotional, and behavioral domains. Likewise, disorders of control can lead to dysregulated emotions and behavior. Other disorders, such as loss of self-awareness, are also implicated in poor psychosocial recovery. Finally, this chapter overviews psychiatric disorders associated with TBI, especially anxiety and depression. For each kind of disorder, the nature of the disorder and its prevalence, as well as theoretical considerations and impact on every day functions, are reviewed.
Collapse
Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
| | - Helen Genova
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, United States
| |
Collapse
|
3
|
Famelart N, Diene G, Çabal-Berthoumieu S, Glattard M, Molinas C, Guidetti M, Tauber M. Equivocal expression of emotions in children with Prader-Willi syndrome: what are the consequences for emotional abilities and social adjustment? Orphanet J Rare Dis 2020; 15:55. [PMID: 32085791 PMCID: PMC7035757 DOI: 10.1186/s13023-020-1333-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/07/2020] [Indexed: 11/25/2022] Open
Abstract
Background People with Prader-Willi Syndrome (PWS) experience great difficulties in social adaptation that could be explained by disturbances in emotional competencies. However, current knowledge about the emotional functioning of people with PWS is incomplete. In particular, despite being the foundation of social adaptation, their emotional expression abilities have never been investigated. In addition, motor and cognitive difficulties - characteristic of PWS - could further impair these abilities. Method To explore the expression abilities of children with PWS, twenty-five children with PWS aged 5 to 10 years were assessed for 1) their emotional facial reactions to a funny video-clip and 2) their ability to produce on demand the facial and bodily expressions of joy, anger, fear and sadness. Their productions were compared to those of two groups of children with typical development, matched to PWS children by chronological age and by developmental age. The analyses focused on the proportion of expressive patterns relating to the target emotion and to untargeted emotions in the children’s productions. Results The results showed that the facial and bodily emotional expressions of children with PWS were particularly difficult to interpret, involving a pronounced mixture of different emotional patterns. In addition, it was observed that the emotions produced on demand by PWS children were particularly poor and equivocal. Conclusions As far as we know, this study is the first to highlight the existence of particularities in the expression of emotions in PWS children. These results shed new light on emotional dysfunction in PWS and consequently on the adaptive abilities of those affected in daily life.
Collapse
Affiliation(s)
- Nawelle Famelart
- CLLE, University of Toulouse, CNRS, Toulouse, France. .,Université Toulouse Jean Jaurès, Maison de la Recherche, Laboratoire CLLE, 5, allée Antonio Machado, 31058, Toulouse Cedex 9, France.
| | - Gwenaelle Diene
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France
| | | | - Mélanie Glattard
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France
| | - Catherine Molinas
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France
| | | | - Maithe Tauber
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France.,CPTP, University of Toulouse, CNRS, INSERM, Toulouse, France
| |
Collapse
|
4
|
Turkstra LS, Duff MC, Politis AM, Mutlu B. Detection of text-based social cues in adults with traumatic brain injury. Neuropsychol Rehabil 2019; 29:789-803. [PMID: 28594270 PMCID: PMC6170715 DOI: 10.1080/09602011.2017.1333012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 05/09/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Written text contains verbal immediacy cues-word form or grammatical cues that indicate positive attitude or liking towards an object, action, or person. We asked if adults with moderate-severe traumatic brain injury (TBI) would respond to these cues, given evidence of TBI-related social communication impairments. METHODS Sixty-nine adults with TBI and 74 healthy comparison (HC) peers read pairs of sentences containing different types of immediacy cues (e.g., speaker A said "these Canadians" vs. B said "those Canadians.") and identified which speaker (A or B) had a more positive attitude towards the underlined entity (Task 1); and pairs of sentences comprised of a context sentence (e.g., Fred is asked, "Did you visit Joan and Sue?") and a statement sentence (Fred says, "I visited Sue and Joan.") and were asked to indicate how much Fred liked or disliked the underlined words (Task 2). RESULTS HC group scores were significantly higher on Task 1, indicating more sensitivity to cues. On Task 2, TBI and HC group ratings differed across cue types and immediacy types, and the TBI group appeared to have less sensitivity to these cues. CONCLUSIONS Findings suggest that TBI-related impairments may reduce sensitivity to subtle social cues in text.
Collapse
Affiliation(s)
- Lyn Siobhan Turkstra
- a Department of Communication Sciences and Disorders , University of Wisconsin-Madison , Madison , USA
- b Neuroscience Training Program and Department of Surgery , University of Wisconsin-Madison , Madison , USA
| | - Melissa Collins Duff
- c Department of Hearing and Speech Sciences , Vanderbilt University , Nashville , USA
| | - Adam Michael Politis
- a Department of Communication Sciences and Disorders , University of Wisconsin-Madison , Madison , USA
- d Rehabilitation Medicine Department , National Institutes of Health , Bethesda , USA
| | - Bilge Mutlu
- e Department of Computer Sciences , University of Wisconsin-Madison , Madison , USA
| |
Collapse
|
5
|
Evans KJ, Evans DL. Interpretation of non-verbal cues by people with and without TBI: understanding relationship intentions. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:377-389. [PMID: 30444068 DOI: 10.1111/1460-6984.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Although long-term social challenges following traumatic brain injury (TBI) are well documented, the challenges of establishing new relationships following TBI are less understood. AIMS To examine how the type of non-verbal cues produced by an unfamiliar communication partner impacts feelings of relationship closeness by people with and without TBI. METHODS & PROCEDURES In this quasi-experimental comparative mixed-group design, participants included 12 male heterosexual adults with moderate/severe TBI and 10 typical comparison peers. An adaptation of the Relationship Closeness Induction Task (RCIT), a 29-item questionnaire, was completed by all participants to induce relationship closeness through reciprocal self-disclosure during conversation. Participants completed the RCIT three separate times in counterbalanced order. Conversational partners for the RCIT were three female actors trained to convey similar verbal answers to the RCIT questions, but to produce different non-verbal cues: solicitation (i.e., flirting), neutral and rejecting. Following each conversation, the participants completed a 10-item Likert-type questionnaire about the experience. OUTCOMES & RESULTS Between- and within-group non-parametric statistical analysis of Likert questions showed non-significant differences between the two participant groups such that both groups consistently rated the female actor who used flirting non-verbal cues higher than the actor who used rejecting non-verbal cues. CONCLUSIONS & IMPLICATIONS These results suggest a small sample of heterosexual males with TBI interpret non-verbal relationship cues in real-time conversations with unfamiliar partners as well as comparison peers. Clinical implications include the need to consider real-time conversation in assessment and treatment planning for social communication goals related to cognitive-communication impairment.
Collapse
Affiliation(s)
- Kelli J Evans
- Western Washington University, Department of Communication Sciences and Disorders, Bellingham, WA, USA
| | - David L Evans
- Western Washington University, Department of Communication Sciences and Disorders, Bellingham, WA, USA
| |
Collapse
|
6
|
Wearne T, Osborne-Crowley K, Rosenberg H, Dethier M, McDonald S. Emotion recognition depends on subjective emotional experience and not on facial expressivity: evidence from traumatic brain injury. Brain Inj 2018; 33:1-11. [PMID: 30296178 DOI: 10.1080/02699052.2018.1531300] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/02/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Recognizing how others feel is paramount to social situations and commonly disrupted following traumatic brain injury (TBI). This study tested whether problems identifying emotion in others following TBI is related to problems expressing or feeling emotion in oneself, as theoretical models place emotion perception in the context of accurate encoding and/or shared emotional experiences. METHODS Individuals with TBI (n = 27; 20 males) and controls (n = 28; 16 males) were tested on an emotion recognition task, and asked to adopt facial expressions and relay emotional memories according to the presentation of stimuli (word and photos). After each trial, participants were asked to self-report their feelings of happiness, anger and sadness. Judges that were blind to the presentation of stimuli assessed emotional facial expressivity. RESULTS Emotional experience was a unique predictor of affect recognition across all emotions while facial expressivity did not contribute to any of the regression models. Furthermore, difficulties in recognizing emotion for individuals with TBI were no longer evident after cognitive ability and experience of emotion were entered into the analyses. CONCLUSIONS Emotion perceptual difficulties following TBI may stem from an inability to experience affective states and may tie in with alexythymia in clinical conditions.
Collapse
Affiliation(s)
- Travis Wearne
- a School of Psychology , University of New South Wales , Sydney , NSW , Australia
| | | | - Hannah Rosenberg
- a School of Psychology , University of New South Wales , Sydney , NSW , Australia
| | - Marie Dethier
- b Department of Psychology: Cognition and Behavior , University of Liege , Liege , Belgium
| | - Skye McDonald
- a School of Psychology , University of New South Wales , Sydney , NSW , Australia
| |
Collapse
|
7
|
Abstract
Thirty years ago, the neuropsychology of emotion started to emerge as a mainstream topic. Careful examination of individual patients showed that emotion, like memory, language, and so on, could be differentially affected by brain disorders, especially in the right hemisphere. Since then, there has been accelerating interest in uncovering the neural architecture of emotion, and the major steps in this process of discovery over the past 3 decades are detailed in this review. In the 1990s, magnetic resonance imaging (MRI) scans provided precise delineation of lesions in the amygdala, medial prefrontal cortex, insula and somatosensory cortex as underpinning emotion disorders. At the same time, functional MRI revealed activation that was bilateral and also lateralized according to task demands. In the 2000s, converging evidence suggested at least two routes to emotional responses: subcortical, automatic and autonomic responses and slower, cortical responses mediating cognitive processing. The discovery of mirror neurons in the 1990s reinvigorated older views that simulation was the means to recognize emotions and empathize with others. More recently, psychophysiological research, revisiting older Russian paradigms, has contributed new insights into how autonomic and other physiological indices contribute to decision making (the somatic marker theory), emotional simulation, and social cognition. Finally, this review considers the extent to which these seismic changes in understanding emotional processes in clinical disorders have been reflected in neuropsychological practice. (JINS, 2017, 23, 719-731).
Collapse
|
8
|
Cassel A, McDonald S, Kelly M, Togher L. Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury. Neuropsychol Rehabil 2016; 29:22-55. [DOI: 10.1080/09602011.2016.1257435] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Anneli Cassel
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Michelle Kelly
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| |
Collapse
|
9
|
Dapelo MM, Bodas S, Morris R, Tchanturia K. Deliberately generated and imitated facial expressions of emotions in people with eating disorders. J Affect Disord 2016; 191:1-7. [PMID: 26599363 DOI: 10.1016/j.jad.2015.10.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/25/2015] [Accepted: 10/27/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with eating disorders have difficulties in socio emotional functioning that could contribute to maintaining the functional consequences of the disorder. This study aimed to explore the ability to deliberately generate (i.e., pose) and imitate facial expressions of emotions in women with anorexia (AN) and bulimia nervosa (BN), compared to healthy controls (HC). METHODS One hundred and three participants (36 AN, 25 BN, and 42 HC) were asked to pose and imitate facial expressions of anger, disgust, fear, happiness, and sadness. Their facial expressions were recorded and coded. RESULTS Participants with eating disorders (both AN and BN) were less accurate than HC when posing facial expressions of emotions. Participants with AN were less accurate compared to HC imitating facial expressions, whilst BN participants had a middle range performance. All results remained significant after controlling for anxiety, depression and autistic features. LIMITATIONS The relatively small number of BN participants recruited for this study. CONCLUSIONS The study findings suggest that people with eating disorders, particularly those with AN, have difficulties posing and imitating facial expressions of emotions. These difficulties could have an impact in social communication and social functioning. This is the first study to investigate the ability to pose and imitate facial expressions of emotions in people with eating disorders, and the findings suggest this area should be further explored in future studies.
Collapse
Affiliation(s)
- Marcela Marin Dapelo
- King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Sergio Bodas
- Consorci Sanitari de Terrassa, Department of Mental Health, Terrassa, Spain
| | - Robin Morris
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Kate Tchanturia
- King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, UK; Ilia State University, Tbilisi, Georgia.
| |
Collapse
|
10
|
Facial emotion recognition deficits following moderate-severe Traumatic Brain Injury (TBI): re-examining the valence effect and the role of emotion intensity. J Int Neuropsychol Soc 2014; 20:994-1003. [PMID: 25396693 DOI: 10.1017/s1355617714000940] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Many individuals who sustain moderate-severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether this "valence effect" might be an artifact of the wide use of static facial emotion stimuli (usually full-blown expressions) which differ in difficulty rather than a real consequence of brain impairment. This study aimed to investigate the valence effect in TBI, while examining emotion recognition across different intensities (low, medium, and high). METHOD Twenty-seven individuals with TBI and 28 matched control participants were tested on the Emotion Recognition Task (ERT). The TBI group was more impaired in overall emotion recognition, and less accurate recognizing negative emotions. However, examining the performance across the different intensities indicated that this difference was driven by some emotions (e.g., happiness) being much easier to recognize than others (e.g., fear and surprise). Our findings indicate that individuals with TBI have an overall deficit in facial emotion recognition, and that both people with TBI and control participants found some emotions more difficult than others. These results suggest that conventional measures of facial affect recognition that do not examine variance in the difficulty of emotions may produce erroneous conclusions about differential impairment. They also cast doubt on the notion that dissociable neural pathways underlie the recognition of positive and negative emotions, which are differentially affected by TBI and potentially other neurological or psychiatric disorders.
Collapse
|
11
|
Walsh J, Eccleston C, Keogh E. Pain communication through body posture: The development and validation of a stimulus set. Pain 2014; 155:2282-90. [DOI: 10.1016/j.pain.2014.08.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 08/14/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
|
12
|
Emotional regulation impairments following severe traumatic brain injury: an investigation of the body and facial feedback effects. J Int Neuropsychol Soc 2013; 19:367-79. [PMID: 23351364 DOI: 10.1017/s1355617712001555] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The object of this study was to evaluate the combined effect of body and facial feedback in adults who had suffered from a severe traumatic brain injury (TBI) to gain some understanding of their difficulties in the regulation of negative emotions. Twenty-four participants with TBI and 28 control participants adopted facial expressions and body postures according to specific instructions and maintained these positions for 10 s. Expressions and postures entailed anger, sadness, and happiness as well as a neutral (baseline) condition. After each expression/posture manipulation, participants evaluated their subjective emotional state (including cheerfulness, sadness, and irritation). TBI participants were globally less responsive to the effects of body and facial feedback than control participants, F(1,50) = 5.89, p = .02, η(2) = .11. More interestingly, the TBI group differed from the Control group across emotions, F(8,400) = 2.51, p = .01, η(2) = .05. Specifically, participants with TBI were responsive to happy but not to negative expression/posture manipulations whereas control participants were responsive to happy, angry, and sad expression/posture manipulations. In conclusion, TBI appears to impair the ability to recognize both the physical configuration of a negative emotion and its associated subjective feeling.
Collapse
|
13
|
Abstract
Severe traumatic brain injury (TBI) leads to physical, neuropsychological, and emotional deficits that interfere with the individual’s capacity to return to his or her former lifestyle. This review focuses on social cognition, that is, the capacity to attend to, recognize and interpret interpersonal cues that guide social behavior. Social cognition entails ‘‘hot’’ processes, that is, emotion perception and emotional empathy and ‘‘cold’’ processes, that is, the ability to infer the beliefs, feelings, and intentions of others (theory of mind: ToM) to see their point of view (cognitive empathy) and what they mean when communicating (pragmatic inference). This review critically examines research attesting to deficits in each of these domains and also examines evidence for theorized mechanisms including specific neural networks, the role of simulation, and non-social cognition. Current research is hampered by small, heterogeneous samples and the inherent complexity of TBI pathology. Nevertheless, there is evidence that facets of social cognition are impaired in this population. New assessment tools to measure social cognition following TBI are required that predict everyday social functioning. In addition, research into remediation needs to be guided by the growing empirical base for understanding social cognition that may yet reveal how deficits dissociate following TBI.
Collapse
|