Face masks impair facial emotion recognition and induce specific emotion confusions

Inferring social signals from the eyes in male schizophrenia

Nonverbal communication habitually leaks out in ways that expose underlying thoughts, true feelings, and integrity of a counterpart. Social cognition is deficient in a wide range of mental disorders, including schizophrenia (SZ). Inferring social signals through the eyes is pivotal for social interaction but remains poorly investigated. The present work aims to fill this gap by examining whether and, if so, how reading language of the eyes is altered in SZ. We focused on male SZ, primarily because the disorder manifests a gender-specific profile. Patients and matched typically developing (TD) individuals were administered the Reading the Mind in the Eyes Test-Modified (RMET-M) and Emotions in Masked Faces (EMF) task that provide comparable visual information. The findings indicate that in SZ, the emotion recognition profile is similar to TD, with a more accurate recognition of some emotions such as fear, neutral expressions, and happiness than the others (sadness and disgust). In SZ, however, this profile is shifted down: all emotions are recognized less accurately than in TD. On the RMET-M, patients are also less precise, albeit they perform better on items with positive valence. In SZ only, recognition accuracy on both tasks is tightly linked to each other. The outcome reveals global challenges for males with SZ in inferring social information in the eyes and calls for remediation programs to shape social cognition. This work offers novel insights into the profiles of social cognitive deficits in mental disorders that differ in their gender prevalence.

Social bonding through shared experiences: the role of emotional intensity

Sharing emotions with other individuals is a widespread phenomenon. Previous research proposed that experiencing intense and similar emotions with other individuals reinforces social bonds. However, several aspects of this phenomenon remain unclear, notably whether social bonding requires the convergence and synchronization of emotions in the group, and whether these effects generalize across positively valenced and negatively valenced emotional contexts. To address these questions, we measured subjective emotional experiences, physiological activity (cardiac, respiratory, electrodermal) and social attitudes in dyads of unacquainted individuals who watched videos in the presence of each other. We manipulated the emotional content of the videos and the type of shared attention between participants, to test for the contribution of interpersonal influence. The results revealed that intense emotions indexed by physiological arousal were associated with the emergence of reciprocal prosocial attitudes within dyads, and that this effect depended on joint attention. We did not observe the convergence and synchronization of emotions within dyads, which suggests that experiencing similar emotions was not necessary for social bonding. We discuss implications of this study for research on collective effervescence and the social consequences of shared experiences.

Duration of face mask exposure matters: evidence from Swiss and Brazilian kindergartners' ability to recognise emotions

Wearing facial masks became a common practice worldwide during the COVID-19 pandemic. This study investigated (1) whether facial masks that cover adult faces affect 4- to 6-year-old children's recognition of emotions in those faces and (2) whether the duration of children's exposure to masks is associated with emotion recognition. We tested children from Switzerland (N = 38) and Brazil (N = 41). Brazil represented longer mask exposure due to a stricter mandate during COVID-19. Children had to choose a face displaying a specific emotion (happy, angry, or sad) when the face wore either no cover, a facial mask, or sunglasses. The longer hours of mask exposure were associated with better emotion recognition. Controlling for the hours of exposure, children were less likely to recognise emotions in partially hideen faces. Moreover, Brazilian children were more accurate in recognising happy faces than Swiss children. Overall, facial masks may negatively impact children's emotion recognition. However, prolonged exposure appears to buffer the lack of facial cues from the nose and mouth. In conclusion, restricting facial cues due to masks may impair kindergarten children's emotion recognition in the short run. However, it may facilitate their broader reading of facial emotional cues in the long run.

'The mirror of the soul?' Inferring sadness in the eyes

The eyes are widely regarded as the mirror of the soul, providing reliable nonverbal information about drives, feelings, and intentions of others. However, it is unclear how accurate emotion recognition is when only the eyes are visible and whether inferring of emotions is altered across healthy adulthood. To fill this gap, the present piece of research was directed at comparing the ability to infer basic emotions in two groups of typically developing females that differed in age. We set a focus on females seeking group homogeneity. In a face-to-face study, in a two-alternative forced choice paradigm (2AFC), participants had to indicate emotions for faces covered by masks. The outcome reveals that although the recognition pattern is similar in both groups, inferring sadness in the eyes substantially improves with age. Inference of sadness is not only more accurate and less variable in older participants, but also positively correlates with age from early through mid-adulthood. Moreover, reading sadness (and anger) is more challenging in the eyes of male posers. A possible impact of poser gender and cultural background, both in expressing and inferring sadness in the eyes, is highlighted.

Lesson learned from the COVID-19 pandemic: toddlers learn earlier to read emotions with face masks

In a prior study we demonstrated that the presence of face masks impairs the human capability of accurately inferring emotions conveyed through facial expressions, at all ages. The degree of impairment posed by face covering was notably more pronounced in children aged between three and five years old. In the current study, we conducted the same test as a follow-up after one year from the onset of the COVID-19 pandemic, when the requirement of wearing face masks was holding in almost all circumstances of everyday life when social interactions occur. The results indicate a noteworthy improvement in recognizing facial expressions with face masks among children aged three to five, compared to the pre-pandemic settings. These findings hold a significant importance, suggesting that toddlers effectively mitigated the social challenges associated with masks use: they overcame initial environmental limitations, improving their capability to interpret facial expressions even in the absence of visual cues from the lower part of the face.

Reading language of the eyes in female depression

Aberrations in non-verbal social cognition have been reported to coincide with major depressive disorder. Yet little is known about the role of the eyes. To fill this gap, the present study explores whether and, if so, how reading language of the eyes is altered in depression. For this purpose, patients and person-by-person matched typically developing individuals were administered the Emotions in Masked Faces task and Reading the Mind in the Eyes Test, modified, both of which contained a comparable amount of visual information available. For achieving group homogeneity, we set a focus on females as major depressive disorder displays a gender-specific profile. The findings show that facial masks selectively affect inferring emotions: recognition of sadness and anger are more heavily compromised in major depressive disorder as compared with typically developing controls, whereas the recognition of fear, happiness, and neutral expressions remains unhindered. Disgust, the forgotten emotion of psychiatry, is the least recognizable emotion in both groups. On the Reading the Mind in the Eyes Test patients exhibit lower accuracy on positive expressions than their typically developing peers, but do not differ on negative items. In both depressive and typically developing individuals, the ability to recognize emotions behind a mask and performance on the Reading the Mind in the Eyes Test are linked to each other in processing speed, but not recognition accuracy. The outcome provides a blueprint for understanding the complexities of reading language of the eyes within and beyond the COVID-19 pandemic.

The social factors behind the mask: contextual effects on trait impressions from faces wearing a face mask

The presence of face masks can significantly impact processes related to trait impressions from faces. In the present research, we focused on trait impressions from faces either wearing a mask or not by addressing how contextual factors may shape such inferences. In Study 1, we compared trait impressions from faces in a phase of the COVID-19 pandemic in which wearing masks was a normative behavior (T1) with those assessed one year later when wearing masks was far less common (T2). Results at T2 showed a reduced positivity in the trait impressions elicited by faces covered by a mask. In Study 2, it was found that trait impressions from faces were modulated by the background visual context in which the target face was embedded so that faces wearing a mask elicited more positive traits when superimposed on an indoor rather than outdoor visual context. Overall, the present studies indicate that wearing face masks may affect trait impressions from faces, but also that such impressions are highly flexible and can significantly fluctuate across time and space.

Exploring the evocative qualities of masks' visual imagery and their associations with adversity and trauma

Introduction

Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations, especially as they relate to viewers' personal experiences of adversities.

Methods

In this exploratory study, we examined the relationship between the visual content of mask images and viewers' responses. In an online survey 699 participants (of n = 1,010 total initial participants) rated 98 masks based on valence, arousal, and personal relevance and completed the Life Events Checklist. The masks included those created by service members (SMs) with traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD), depicting physical, psychological, and moral injuries and matched neutral masks created by creative arts therapists and arts in health scholars.

Findings

The findings indicated that responses to mask image content (traumatic versus neutral) were associated with viewers' personal history of adversity and trauma. Specifically, images representing injury/trauma provoked stronger reactions on valence and arousal than neutral images. Moreover, participants with personal histories of trauma had heightened emotional responses to distressing imagery.

Discussion

These findings have implications for art therapists as well as for clinical and general populations in that these results highlight the potential impact of distressing imagery particularly for individuals with personal histories of experiencing or witnessing traumatic events.

The impact of face coverings on audio-visual contributions to communication with conversational speech

The use of face coverings can make communication more difficult by removing access to visual cues as well as affecting the physical transmission of speech sounds. This study aimed to assess the independent and combined contributions of visual and auditory cues to impaired communication when using face coverings. In an online task, 150 participants rated videos of natural conversation along three dimensions: (1) how much they could follow, (2) how much effort was required, and (3) the clarity of the speech. Visual and audio variables were independently manipulated in each video, so that the same video could be presented with or without a superimposed surgical-style mask, accompanied by one of four audio conditions (either unfiltered audio, or audio-filtered to simulate the attenuation associated with a surgical mask, an FFP3 mask, or a visor). Hypotheses and analyses were pre-registered. Both the audio and visual variables had a statistically significant negative impact across all three dimensions. Whether or not talkers' faces were visible made the largest contribution to participants' ratings. The study identifies a degree of attenuation whose negative effects can be overcome by the restoration of visual cues. The significant effects observed in this nominally low-demand task (speech in quiet) highlight the importance of the visual and audio cues in everyday life and that their consideration should be included in future face mask designs.

Recognizing and Looking at Masked Emotional Faces in Alexithymia

Alexithymia is a clinically relevant personality construct characterized by difficulties identifying and communicating one's emotions and externally oriented thinking. Alexithymia has been found to be related to poor emotion decoding and diminished attention to the eyes. The present eye tracking study investigated whether high levels of alexithymia are related to impairments in recognizing emotions in masked faces and reduced attentional preference for the eyes. An emotion recognition task with happy, fearful, disgusted, and neutral faces with face masks was administered to high-alexithymic and non-alexithymic individuals. Hit rates, latencies of correct responses, and fixation duration on eyes and face mask were analyzed as a function of group and sex. Alexithymia had no effects on accuracy and speed of emotion recognition. However, alexithymic men showed less attentional preference for the eyes relative to the mask than non-alexithymic men, which was due to their increased attention to face masks. No fixation duration differences were observed between alexithymic and non-alexithymic women. Our data indicate that high levels of alexithymia might not have adverse effects on the efficiency of emotion recognition from faces wearing masks. Future research on gaze behavior during facial emotion recognition in high alexithymia should consider sex as a moderating variable.

Investigating the impact of surgical masks on behavioral reactions to facial emotions in the COVID-19 era

Introduction

The widespread use of surgical masks during the COVID-19 pandemic has posed challenges in interpreting facial emotions. As the mouth is known to play a crucial role in decoding emotional expressions, its covering is likely to affect this process. Recent evidence suggests that facial expressions impact behavioral responses only when their emotional content is relevant to subjects' goals. Thus, this study investigates whether and how masked emotional faces alter such a phenomenon.

Methods

Forty participants completed two reaching versions of the Go/No-go task in a counterbalanced fashion. In the Emotional Discrimination Task (EDT), participants were required to respond to angry, fearful, or happy expressions by performing a reaching movement and withholding it when a neutral face was presented. In the Gender Discrimination Task (GDT), the same images were shown, but participants had to respond according to the poser's gender. The face stimuli were presented in two conditions: covered by a surgical mask (masked) or without any covering (unmasked).

Results

Consistent with previous studies, valence influenced behavioral control in the EDT but not in the GDT. Nevertheless, responses to facial emotions in the EDT exhibited significant differences between unmasked and masked conditions. In the former, angry expressions led to a slowdown in participants' responses. Conversely, in the masked condition, behavioral reactions were impacted by fearful and, to a greater extent, by happy expressions. Responses to fearful faces were slower, and those to happy faces exhibited increased variability in the masked condition compared to the unmasked condition. Furthermore, response accuracy to masked happy faces dramatically declined compared to the unmasked condition and other masked emotions.

Discussion

In sum, our findings indicate that surgical masks disrupt reactions to emotional expressions, leading people to react less accurately and with heightened variability to happy expressions, provided that the emotional dimension is relevant to people's goals.

Accuracy and Speed of Emotion Recognition With Face Masks

Wearing face masks is one of the important actions to prevent the spread of COVID-19 among people around the world. Nevertheless, social interaction is limited via masks, and this impacts the accuracy and speed of emotional perception. In the present study, we assess the impact of mask-wearing on the accuracy and speed of emotion recognition. Fifty people (female n = 39, male n = 11) aged 19-28 participated in the study (M = 21.1 years). We used frontal photos of a Kosova woman who belonged to the same participants' age group, with a grey background. Twelve different pictures were used that showed the emotional states of fear, joy, sadness, anger, neutrality, and disgust, in masked and unmasked conditions. The experiment was conducted in a controlled laboratory setting. Participants were faster for identifying emotions like joy (1.507 ms) and neutral (1.971 ms). The participants were more accurate (emotions identification) in unmasked faces (M = 85.7%) than in masked faces (M = 73.8%), F(1,98) = 20.73, MSE = 1027.66, p ≤ .001, partial η² = 0.17. Masks make confusion and reduce the accuracy and speediness of emotional detection. This may have a notable impact on social interactions among peoples.

Do masks cover more than just a face? A study on how facemasks affect the perception of emotional expressions according to their degree of intensity

Emotional facial expressions convey crucial information in nonverbal communication and serve as a mediator in face-to-face relationships. Their recognition would rely on specific facial traits depending on the perceived emotion. During the COVID-19 pandemic, wearing a facemask has thus disrupted the human ability to read emotions from faces. Yet, these effects are usually assessed across studies from faces expressing stereotypical and exaggerated emotions, which is far removed from real-life conditions. The objective of the present study was to evaluate the impact of facemasks through an emotion categorization task using morphs ranging from a neutral face and an expressive face (anger, disgust, fear, happiness, and sadness) (from 0% neutral to 100% expressive in 20% steps). Our results revealed a strong impact of facemasks on the recognition of expressions of disgust, happiness, and sadness, resulting in a decrease in performance and an increase in misinterpretations, both for low and high levels of intensity. In contrast, the recognition of anger and fear, as well as neutral expression, was found to be less impacted by mask-wearing. Future studies should address this issue from a more ecological point of view with the aim of taking concrete adaptive measures in the context of daily interactions.

Effect of Face Masking on Transmission of SARS-CoV-2

The efficacy of face masking for the public is not convincing to prevent the transmission of respiratory tract viruses such as SARS-CoV-2 when the criteria of evidence-based medicine are applied. This finding is mainly explained by the results from randomized-controlled trials (RCTs) when a high prevalence of the infection and a high compliance in mask wearing was assured. Throughout these studies no significant protective effect was observed. Observational studies with surgical masks describe a significant protective effect, but are prone to confounders such as physical distance. Respirators do not provide an additional health benefit compared to surgical or medical masks (RCTs). Community masks can even increase the risk of infection (RCTs). Based on the categories of evidence-based medicine, the efficacy results can best be categorized as conflicting evidence. Many relevant adverse events are described when masks are worn for hours such as dyspnea (12.2-52.8%), headache (3.9-73.4%), pruritus (0.0-60.0%), and skin reactions (0.0-85.0%). Their frequency is often higher with respirators. In future pandemics, masks should only be recommended or mandated for settings in which a clinically relevant health benefit can be expected, defined as the prevention of severe, critical or fatal disease, that clearly outweighs the expectable associated adverse reactions.

Impact of COVID-19 on the Mental Health of Psychiatric Inpatients

Purpose

The perceptions and responses to acute states of emergency may vary for people experiencing serious mental illness (SMI). Therefore, studying the mental health toll of the COVID-19 pandemic on psychiatric inpatients can inform psychiatric care in the event of future global crises. The objective of this study was to determine if there was a difference in the incidence of mental health manifestations in an adult inpatient state psychiatric facility during the COVID-19 pandemic, compared to the immediately preceding year.

Methods

Medication administration history for patients who utilized an as needed (PRN) medication for anxiety, agitation, or psychosis between March 1, 2020, and February 28, 2021, were analyzed. Secondary data on the incidence of restraints and seclusions were also examined.

Results

The total number of PRN medications was higher during the pre-COVID-19 time frame than during the pandemic (8,139 vs. 7,630), but this was not statistically significant. The following assessments were statistically significant: predominance of psychosis as a psychiatric symptom during the COVID-19 time frame (557 vs. 389), and the difference in PRN medication administration times between time frames as categorized by day (3,741 vs. 2,623), evening (3,844 vs. 4,239), and night (554 vs. 768).

Conclusion

During the height of the COVID-19 pandemic, the use of PRN medications for psychosis increased and the use of PRN medications for anxiety and agitation decreased among inpatients at a state psychiatric hospital. These results suggest that experiencing a worldwide pandemic in a psychiatric inpatient facility may be protective in some respects but may exacerbate symptoms of psychosis.

Emotions behind a mask: the value of disgust

The impact of face masks on social cognition and interaction became a popular topic due to the long-lasting COVID-19 pandemic. This theme persists in the focus of attention beyond the pandemic, since face covering not only reduces the overall amount of face information available but also introduces biases and prejudices affecting social perception at large. Many questions are still open. One of them is whether gender of beholders affects inferring of emotions covered by face masks. Reading covered faces may be particularly challenging for individuals with mental disorders, most of which are gender-specific. Previous findings are not only sparse, but inconclusive because most research had been conducted online with resulting samples heavily dominated by females. Here in a face-to-face study, females and males were presented with a randomized set of faces covered by masks. In a two-alternative forced-choice paradigm, participants had to indicate facial emotions displayed by posers. In general, the outcome dovetails with earlier findings that face masks affect emotion recognition in a dissimilar way: Inferring some emotions suffers more severely than others, with the most pronounced influence of mask wearing on disgust and close to ceiling recognition of fear and neutral expressions. Contrary to our expectations, however, males were on overall more proficient in emotion recognition. In particular, males substantially excelled in inferring disgust. The findings help to understand gender differences in recognition of disgust, the forgotten emotion of psychiatry, that is of substantial value for a wide range of mental disorders including schizophrenia. Watch Prof. Marina Pavlova discussing this her work and this article: https://vimeo.com/860126397/5966610f49?share=copy .