Mask exposure during COVID-19 changes emotional face processing

Impact of partial occlusion of the face on multisensory emotion perception: Comparison of pre- and post-COVID-19 pandemic

We perceive and understand others' emotional states from multisensory information such as facial expressions and vocal cues. However, such cues are not always available or clear. Can partial loss of visual cues affect multisensory emotion perception? In addition, the COVID-19 pandemic has led to the widespread use of face masks, which can reduce some facial cues used in emotion perception. Thus, can frequent exposure to masked faces affect emotion perception? We conducted an emotion perception task using audio-visual stimuli that partially occluded the speaker's face. Participants were simultaneously shown a face and voice that expressed either congruent or incongruent emotions and judged whether the person was happy or angry. The stimuli included videos in which the eyes or mouth were partially covered and where the whole face was visible. Our findings showed that, when facial cues were partially occluded, participants relied more on vocal cues for emotion recognition. Moreover, when the mouth was covered, participants relied less on vocal cues after the pandemic compared to before. These findings indicate that partial face masking and prolonged exposure to masked faces can affect multisensory emotion perception. In unimodal emotion perception from only facial cues, accuracy also improved after the pandemic compared to before for faces with the mouth occluded. Therefore, changes in the reliance on vocal cues in multisensory emotion perception during the pandemic period could be explained by improved facial emotion perception from the eye region.

The impact of partially covered faces on trust attribution, sharing resources, and perceived fairness of one's own choices in Ultimatum Game

Covered faces have been linked with impaired emotion recognition; yet, it is entirely unexplored how an occlusion due to face masks may affect individuals' behaviour in economic decisions. Across two studies, we explored whether partially covered faces (due to mask wearing or a horizontal black bar) and emotion displayed by the responder influence peoples' sharing behaviour in the Ultimatum Game and the perceived fairness of one's proposal.Study 1 showed participants were more willing to equally share their resources with a happy face (compared to a neutral one). In addition, they were more willing to make a fair proposal when the person displayed was not wearing a face mask. Our results also provide evidence that, when people had to judge how fair their proposal was, participants rated a fair proposal as fairer when responders showed happy faces without masks, while unfair proposals were rated as fairer with happy masked faces; similarly, angry faces led to fairer ratings for fair offers without masks and unfair offers with masks. Study 2 partially confirmed previous results, highlighting how a simple occlusion on the face does not have a direct effect on the proposal but moderates the effect of the displayed emotions.These findings indicate that social interactions might be affected by face occlusion, especially when it is represented by a face mask. Indeed, people might judge the same behaviour in different ways based on the fact that their counterpart has a partially covered face.

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.

Social emotional processes during the third wave of COVID-19: Results from a close replication study in a Turkish sample

Until recently, for almost 3 years, we used face masks to protect against COVID-19. Face masks disrupted our perception of socially relevant information, and impacted our social judgements as a result of the new social norms around wearing masks imposed by the pandemic. To shed light on such pandemic-induced changes in social emotional processes, Calbi et al. analysed data from an Italian sample collected in Spring 2020. They assessed valence, social distance and physical distance ratings for neutral, happy and angry male and female faces covered with a scarf or a mask. A year later, we used the same stimuli to investigate the same measures in a Turkish sample. We found that females attributed more negative valence ratings than males to angry faces, and that angry and neutral faces of females were rated more negatively than those of males. Scarf stimuli were evaluated more negatively in terms of valence. Participants attributed greater distance to more negative faces (angry > neutral > happy) and to scarf than the mask stimuli. Also, females attributed greater social and physical distance than males. These results may be explained by gender-stereotypic socialisation processes, and changes in people's perception of health behaviours during the pandemic.

Influence of child and adult faces with face masks on emotion perception and facial mimicry

Emotional mimicry, the imitation of others' emotion expressions, is related to increased interpersonal closeness and better interaction quality. Yet, little research has focused on the effect of face masks on emotional mimicry and none on (masked) child faces. To address this gap, we conducted an online experiment (N = 235, German sample, adult perceivers). Masks reduced emotion recognition accuracy for all expressions, except in the case of anger in masked child faces, where perceived anger was even increased. Perceived interpersonal closeness was reduced for masked happy and sad faces. For both child and adult expressers, masks reduced facial mimicry of happy expressions, with no mask effects for sadness and anger expression. A stronger mask effect on facial happiness mimicry of child faces was mediated by the degree of emotion recognition accuracy. Smiles shown by masked children were not recognized well, likely due to the absence of wrinkles around the eyes in child faces. Independent of masks, sadness shown by children was mimicked even more strongly than when shown by adults. These results provide evidence for facial mimicry of child expressions by adult perceivers and show that the effects of face masks on emotion communication may vary when children wear them.

Face masks influence emotion judgments of facial expressions: a drift-diffusion model

Face masks slow the spread of SARS-CoV-2, but it has been unknown how masks might reshape social interaction. One important possibility is that masks may influence how individuals communicate emotion through facial expressions. Here, we clarify to what extent-and how-masks influence facial emotion communication, through drift-diffusion modeling (DDM). Over two independent pre-registered studies, conducted three and 6 months into the COVID-19 pandemic, online participants judged expressions of 6 emotions (anger, disgust, fear, happiness, sadness, surprise) with the lower or upper face "masked" or unmasked. Participants in Study 1 (N = 228) correctly identified expressions above chance with lower face masks. However, they were less likely-and slower-to correctly identify these expressions relative to without masks, and they accumulated evidence for emotion more slowly-via decreased drift rate in DDM. This pattern replicated and intensified 3 months later in Study 2 (N = 264). These findings highlight how effectively individuals still communicate with masks, but also explain why they can experience difficulties communicating when masked. By revealing evidence accumulation as the underlying mechanism, this work suggests that time-sensitive situations may risk miscommunication with masks. This research could inform critical interventions to promote continued mask wearing as needed.

When less is not more: the effect of transparent masks on facial attractiveness judgment

During the COVID-19 pandemic, face masks have been widely used in daily life. Previous studies have suggested that faces wearing typical masks that occlude the lower half of the face are perceived as more attractive than face without masks. However, relatively little work has been done on how transparent masks that reveal the lower half of the face affect the judgment of facial attractiveness. To investigate the effect of transparent masks on the perceived attractiveness, in the current study, we asked participants to rate the attractiveness of faces without masks and with a typical opaque mask and a transparent mask. The results showed that faces wearing opaque masks were evaluated as more attractive than those wearing transparent masks or no masks. The benefit of opaque masks was more pronounced in faces that were initially evaluated as unattractive. Interestingly, wearing transparent masks decreased the perceived attractiveness of faces but only for the faces initially rated as attractive, possibly because of the visual distortion of the lower half of the face by transparent masks. In summary, we found that opaque and transparent masks have different effects on perceived attractiveness, depending on the attractiveness of faces. Given benefits of transparent masks in socio-emotional and cognitive processing, it would be important to further understand the effect of transparent masks on face information processing.

Trends in eyebrow makeup after COVID-19 and long-COVID era

Background and Objectives

The coronavirus disease-19 (COVID-19) pandemic, which began in 2019, is threatening millions of people around the world. Coronavirus, a severe acute respiratory syndrome, made it mandatory to wear masks, it was carried out through public awareness and review of changes in cosmetics.

Methods

This literature review paper was written by referring to keywords such as "Eyebrow," "Permanent Make-up," "Microblading," "Make-up," and "COVID-19." The study selected a total of 485 references using representative journal search sites such as PubMed, Google Scholar, ResearchGate, RISS, DBPia, and CrossRef, of which a total of 43 papers were selected at the final stage from 2000 to 2022 using PRISMA flow diagram.

Results

With the wearing of a mask due to COVID-19, we are paying attention to the change in the makeup trend caused by the preference for easy eye makeup.

Conclusions

This narrative review understands that eyebrow makeup has a significant impact on human images due to changes in makeup methods after the COVID-19 pandemic. It is expected to be used as important data for the rapidly growing semi-permanent makeup market.

Clinical Psychology and the COVID-19 Pandemic: A Mixed Methods Survey Among Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT)

Background

The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists' views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists' and psychotherapists' in their new working conditions, and understand their needs and priorities.

Method

Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey.

Results

Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified.

Conclusions

Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.

The effect of masks on the recognition of facial expressions: A true-to-life study on the perception of basic emotions

Mouth-to-nose face masks became ubiquitous due to the COVID-19 pandemic. This ignited studies on the perception of emotions in masked faces. Most of these studies presented still images of an emotional face with a face mask digitally superimposed upon the nose-mouth region. A common finding of these studies is that smiles become less perceivable. The present study investigated the recognition of basic emotions in video sequences of faces. We replicated much of the evidence gathered from presenting still images with digitally superimposed masks. We also unearthed fundamental differences in comparison to existing studies with regard to the perception of smile which is less impeded than previous studies implied.

The role of face masks within in-patient psychotherapy: Results of a survey among inpatients and healthcare professionals

Introduction

Face-to-face medical and psychotherapeutic treatments during the Corona pandemic often involve patients and health care providers wearing face masks. We performed a pilot survey assessing the subjective experience of wearing face masks during psychotherapy sessions regarding (i) feasibility, (ii) psychotherapeutic treatment and (iii) communication, emotion and working alliance in patients and healthcare professionals.

Methods

A total of n = 62 inpatients (RR = 95.4%) and n = 33 healthcare professionals (RR = 86.8%) at an academic department of Psychosomatic Medicine and Psychotherapy participated in this survey anonymously. The items of the questionnaire were created by the interprofessional expert team and were based on existing instruments: (i) the Therapeutic Relationship Questionnaire and (ii) the German translation of Yalom's Questionnaire on Experiencing in Group Psychotherapy.

Results

The majority of patients rate their psychotherapy as highly profitable despite the mask. In individual therapy, face masks seem to have a rather low impact on subjective experience of psychotherapy and the relationship to the psychotherapist. Most patients reported using alternative facial expressions and expressions. In the interactional group therapy, masks were rather hindering. On the healthcare professional side, there were more frequent negative associations of face masks in relation to (i) experiencing connectedness with colleagues, (ii) forming relationships, and (iii) therapeutic treatment.

Discussion

Information should be given to patients about the possible effects of face masks on the recognition of emotions, possible misinterpretations and compensation possibilities through alternative stimuli (e.g., eye area) and they should be encouraged to ask for further information. Especially in group therapy, with patients from other cultural backgrounds and in cases of need for help (e.g., hearing impairment) or complex disorders, appropriate non-verbal gestures and body language should be used to match the intended emotional expression.

Face masks have a limited effect on the feeling of being looked at

Introduction

Wearing face masks has been promoted as an effective measure to reduce the spread of COVID-19. Because face masks cover a major part of the face, they have detrimental effects on various aspects of social cognition. Yet, a highly important feature of the face is not occluded by face masks: the eyes. The eyes play an important role in social interactions: knowing where another person is looking is of central importance when interacting with others. Recent research has reported an attentional shift toward the eye region as a consequence of the widespread exposure to face masks. However, no study has yet investigated the influence of face masks on the perception of eye gaze direction. Here we investigated whether face masks have an effect on the feeling of being looked at. Assuming an attentional shift toward the eyes, we might expect more accurate gaze perception in faces wearing face masks.

Methods

Sixty-five participants decided for a series of realistic avatar faces whether each face was making eye contact or not. Half of the faces wore face masks, the other half did not. For each participant and separately for each condition (mask vs. no mask), we calculated the cone of direct gaze (CoDG), a commonly used measure to quantify the range of gaze angles within which an observer assumes mutual gaze.

Results

Contrary to our expectations, results show that mutual gaze is not recognized more accurately in masked faces. Rather, the CoDG was, on average, slightly wider for faces wearing masks compared to faces without masks.

Discussion

Notwithstanding the relatively small effect of face mask, these findings potentially have implications on our social interactions. If we inadvertently feel looked at by an onlooker, we may react inappropriately by reciprocating the alleged approach orientation.

How Are You Feeling? Interpretation of Emotions through Facial Expressions of People Wearing Different Personal Protective Equipment: An Observational Study

(1) Background: The perception of others’ emotions based on non-verbal cues, such as facial expressions, is fundamental for interpersonal communication and mutual support. Using personal protection equipment (PPE) in a work environment during the SAR-CoV-2 pandemic challenged health professionals’ ability to recognise emotions and expressions while wearing PPE. The working hypothesis of this study was that the increased limitation of facial visibility, due to the use of a personal protective device, would interfere with the perception of basic emotions in the participants. (2) Methods: Through a cross-sectional descriptive study, the present research aimed to analyse the identification of four basic emotions (happiness; sadness; fear/surprise; and disgust/anger) through three types of PPE (FFP2 respirator, protective overall and powered air-purifying respirator (PAPR)), by using 32 photographs. The study was conducted using volunteer participants who met the inclusion criteria (individuals older than 13 without cognitive limitations). Participants had to recognise the emotions of actors in photographs that were randomly displayed in an online form. (3) Results: In general, the 690 participants better recognised happiness and fear, independently of the PPE utilised. Women could better identify different emotions, along with university graduates and young and middle-aged adults. Emotional identification was at its worst when the participants wore protective overalls (5.42 ± 1.22), followed by the PAPR (5.83 ± 1.38); the best scores were obtained using the FFP2 masks (6.57 ± 1.20). Sadness was the least recognised emotion, regardless of age. (4) Conclusions: The personal protective devices interfere in the recognition of emotions, with the protective overalls having the greatest impact, and the FFP2 mask the least. The emotions that were best recognised were happiness and fear/surprise, while the least recognised emotion was sadness. Women were better at identifying emotions, as well as participants with higher education, and young and middle-aged adults.

Communicating and reading emotion with masked faces in the Covid era: A short review of the literature

Face masks have proven to be key to slowing down the SARS-Cov2 virus spread in the COVID-19 pandemic context. However, wearing face masks is not devoid of "side-effects", at both the physical and psychosocial levels. In particular, masks hinder emotion reading from facial expressions as they hide a significant part of the face. This disturbs both holistic and featural processing of facial expressions and, therefore, impairs emotion recognition, and influences many aspects of human social behavior. Communication in general is disrupted by face masks, as they modify the wearer's voice and prevent the audience from using lip reading or other non-verbal cues for speech comprehension. Individuals suffering from psychiatric conditions with impairment of communication, are at higher risk of distress because masks increase their difficulties to read emotions from faces. The identification and acknowledgement of these "side-effects" on communication are necessary because they warrant further work on adaptive solutions that will help foster the use of face masks by the greatest number.

Exploring the role of COVID-19 pandemic-related changes in social interactions on preschoolers' emotion labeling

During the COVID-19 pandemic people were increasingly obliged to wear facial masks and to reduce the number of people they met in person. In this study, we asked how these changes in social interactions are associated with young children's emotional development, specifically their emotion recognition via the labeling of emotions. Preschoolers labeled emotional facial expressions of adults (Adult Faces Task) and children (Child Faces Task) in fully visible faces. In addition, we assessed children's COVID-19-related experiences (i.e., time spent with people wearing masks, number of contacts without masks) and recorded children's gaze behavior during emotion labeling. We compared different samples of preschoolers (4.00–5.75 years): The data for the no-COVID-19-experience sample were taken from studies conducted before the pandemic (Adult Faces Task: N = 40; Child Faces Task: N = 30). The data for the with-COVID-19-experience sample (N = 99) were collected during the COVID-19 pandemic in Switzerland between June and November 2021. The results did not indicate differences in children's labeling behavior between the two samples except for fearful adult faces. Children with COVID-19-experience more often labeled fearful faces correctly compared to children with no COVID-19 experience. Furthermore, we found no relations between children's labeling behavior, their individual COVID-19-related experiences, and their gaze behavior. These results suggest that, even though the children had experienced differences in the amount and variability of facial input due to the pandemic, they still received enough input from visible faces to be able to recognize and label different emotions.

A practical test of the link between perceived identifiability and prosociality with two field studies

Covering the face with masks in public settings has been recommended since the start of the pandemic. Because faces provide information about identity, and that face masks hide a portion of the face, it is plausible to expect individuals who wear a mask to consider themselves less identifiable. Prior research suggests that perceived identifiability is positively related to prosocial behavior, and with two pre-registered field studies (total N = 5706) we provide a currently relevant and practical test of this relation. Our findings indicate that mask wearers and non-wearers display equivalent levels of helping behavior (Studies 1 and 2), although mask wearers have a lower level of perceived identifiability than those without a mask (Study 2). Overall, our findings suggest that claims that face masks are related to selfish behavior are not warranted, and that there is no practical link between perceived identifiability and prosocial behavior.

Mask wearing affects emotion perception

To reduce the spread of COVID-19, mask wearing has become ubiquitous in much of the world. We studied the extent to which masks impair emotion recognition and dampen the perceived intensity of facial expressions by naturalistically inducing positive, neutral, and negative emotions in individuals while they were masked and unmasked. Two groups of online participants rated the emotional intensity of each presented image. One group rated full faces (N=104); the other (N=102) rated cropped images where only the upper face was visible. We found that masks impaired the recognition of and rated intensity of positive emotions. This happened even when the faces were cropped and the lower part of the face was not visible. Masks may thus reduce positive emotion and/or expressivity of positive emotion. However, perception of negativity was unaffected by masking, perhaps because unlike positive emotions like happiness which are signaled more in the mouth, negative emotions like anger rely more on the upper face.

Masked emotions: Do face mask patterns and colors affect the recognition of emotions?

Previous research has shown that face masks impair the ability to perceive social information and the readability of emotions. These studies mostly explored the effect of standard medical, often white, masks on emotion recognition. However, in reality, many individuals prefer masks with different styles. We investigated whether the appearance of the mask (pattern: angular vs. curvy and color: black vs. white) affected the recognition of emotional states. Participants were asked to identify the emotions on faces covered by masks with different designs. The presence of masks resulted in decreasing accuracy and confidence and increasing reaction times, indicating that masks impair emotion recognition. There were no significant effects of angularity versus curvature or color on emotion recognition, which suggests that mask design may not impair the recognition beyond the effect of mere mask wearing. Besides, we found relationships between individual difference variables such as mask wearing attitudes, mask design preferences, individual traits and emotion recognition. The majority of participants demonstrated positive attitudes toward mask wearing and preferred non-patterned black and white masks. Preferences for white masks were associated with better emotion recognition of masked faces. In contrast, those with negative attitudes toward masks showed marginally poorer performance in emotion recognition for masked faces, and preferred patterned more than plain masks, perhaps viewing masks as a fashion item rather than a necessity. Moreover, preferences to wear patterned masks were negatively related to actual wearing of masks indoors and perceived risks of COVID.

How does the presence of a surgical face mask impair the perceived intensity of facial emotions?

The use of surgical-type face masks has become increasingly common during the COVID-19 pandemic. Recent findings suggest that it is harder to categorise the facial expressions of masked faces, than of unmasked faces. To date, studies of the effects of mask-wearing on emotion recognition have used categorisation paradigms: authors have presented facial expression stimuli and examined participants’ ability to attach the correct label (e.g., happiness, disgust). While the ability to categorise particular expressions is important, this approach overlooks the fact that expression intensity is also informative during social interaction. For example, when predicting an interactant’s future behaviour, it is useful to know whether they are slightly fearful or terrified, contented or very happy, slightly annoyed or angry. Moreover, because categorisation paradigms force observers to pick a single label to describe their percept, any additional dimensionality within observers’ interpretation is lost. In the present study, we adopted a complementary emotion-intensity rating paradigm to study the effects of mask-wearing on expression interpretation. In an online experiment with 120 participants (82 female), we investigated how the presence of face masks affects the perceived emotional profile of prototypical expressions of happiness, sadness, anger, fear, disgust, and surprise. For each of these facial expressions, we measured the perceived intensity of all six emotions. We found that the perceived intensity of intended emotions (i.e., the emotion that the actor intended to convey) was reduced by the presence of a mask for all expressions except for anger. Additionally, when viewing all expressions except surprise, masks increased the perceived intensity of non-intended emotions (i.e., emotions that the actor did not intend to convey). Intensity ratings were unaffected by presentation duration (500ms vs 3000ms), or attitudes towards mask wearing. These findings shed light on the ambiguity that arises when interpreting the facial expressions of masked faces.

“What Is Hidden behind the Mask?” Facial Emotion Recognition at the Time of COVID-19 Pandemic in Cognitively Normal Multiple Sclerosis Patients

Social cognition deficits have been described in people with multiple sclerosis (PwMS), even in absence of a global cognitive impairment, affecting predominantly the ability to adequately process emotions from human faces. The COVID-19 pandemic has forced people to wear face masks that might interfere with facial emotion recognition. Therefore, in the present study, we aimed at investigating the ability of emotion recognition in PwMS from faces wearing masks. We enrolled a total of 42 cognitively normal relapsing–remitting PwMS and a matched group of 20 healthy controls (HCs). Participants underwent a facial emotion recognition task in which they had to recognize from faces wearing or not surgical masks which of the six basic emotions (happiness, anger, fear, sadness, surprise, disgust) was presented. Results showed that face masks negatively affected emotion recognition in all participants (p < 0.001); in particular, PwMS showed a global worse accuracy than HCs (p = 0.005), mainly driven by the “no masked” (p = 0.021) than the “masked” (p = 0.064) condition. Considering individual emotions, PwMS showed a selective impairment in the recognition of fear, compared with HCs, in both the conditions investigated (“masked”: p = 0.023; “no masked”: p = 0.016). Face masks affected negatively also response times (p < 0.001); in particular, PwMS were globally hastier than HCs (p = 0.024), especially in the “masked” condition (p = 0.013). Furthermore, a detailed characterization of the performance of PwMS and HCs in terms of accuracy and response speed was proposed. Results from the present study showed the effect of face masks on the ability to process facial emotions in PwMS, compared with HCs. Healthcare professionals working with PwMS at the time of the COVID-19 outbreak should take into consideration this effect in their clinical practice. Implications in the everyday life of PwMS are also discussed.