The Eyes Have It: Psychotherapy in the Era of Masks.

Nonverbal communication is integral to the success of psychotherapy and facial expression is an important component of nonverbal communication. The SARS CoV-2 pandemic has caused alterations in how psychotherapy services are provided. In this paper, potential issues that may arise from conducting psychotherapy when both the patient and therapist are wearing masks are explored. These include higher likelihood of misidentifying facial expression, especially when expression is incongruent with body language, and when the lower face is more important for correct identification of emotion. These issues may be particularly problematic for patient populations for whom emotion recognition may be a problem at baseline, or for those more prone to biases in emotional recognition. Suggestions are made for therapists to consider when seeing patients in-person when masks are necessary.

Investigating the social cognition phenotypes in children, adolescents, and adults with epilepsy.

In recent years, clinical and neuropsychological assessment of patients with epilepsy has dedicated increasing attention to social cognition (SC), which is relevant to interpersonal relations, psychological well-being, and autonomy. The components of SC are supported by distinct but interlinked brain regions that may be affected by focal and generalized epilepsy. This special issue sought to describe some of the societal, clinical, and pathophysiological correlates of SC in patients with epilepsy and healthy subjects, highlighting some of the questions key to clinical care and research. This article is part of the Special Issue "Epilepsy and social cognition across the lifespan".

Individuals with and without child maltreatment experiences are evaluated similarly and do not differ in facial affect display at zero- and first-acquaintance.

BACKGROUND: Individuals with a history of child maltreatment (CM) are more often disliked, rejected and victimized compared to individuals without such experiences. However, contributing factors for these negative evaluations are so far unknown. OBJECTIVE: Based on previous research on adults with borderline personality disorder (BPD), this preregistered study assessed whether negative evaluations of adults with CM experiences, in comparison to unexposed controls, are mediated by more negative and less positive facial affect display. Additionally, it was explored whether level of depression, severity of CM, social anxiety, social support, and rejection sensitivity have an influence on ratings. METHODS: Forty adults with CM experiences (CM +) and 40 non-maltreated (CM-) adults were filmed for measurement of affect display and rated in likeability, trustworthiness, and cooperativeness by 100 independent raters after zero-acquaintance (no interaction) and 17 raters after first-acquaintance (short conversation). RESULTS: The CM + and the CM- group were neither evaluated significantly different, nor showed significant differences in affect display. Contrasting previous research, higher levels of BPD symptoms predicted higher likeability ratings (p = .046), while complex post-traumatic stress disorder symptoms had no influence on ratings. CONCLUSIONS: The non-significant effects could be attributed to an insufficient number of participants, as our sample size allowed us to detect effects with medium effect sizes (f2 = .16 for evaluation; f2 = .17 for affect display) with a power of .95. Moreover, aspects such as the presence of mental disorders (e.g., BPD or post-traumatic stress disorder), might have a stronger impact than CM per se. Future research should thus further explore conditions (e.g., presence of specific mental disorders) under which individuals with CM are affected by negative evaluations as well as factors that contribute to negative evaluations and problems in social relationships.

Non-autistic adults can recognize posed autistic facial expressions: Implications for internal representations of emotion.

Autistic people report that their emotional expressions are sometimes misunderstood by non-autistic people. One explanation for these misunderstandings could be that the two neurotypes have different internal representations of emotion: Perhaps they have different expectations about what a facial expression showing a particular emotion looks like. In three well-powered studies with non-autistic college students in the United States (total N = 632), we investigated this possibility. In Study 1, participants recognized most facial expressions posed by autistic individuals more accurately than those posed by non-autistic individuals. Study 2 showed that one reason the autistic expressions were recognized more accurately was because they were better and more intense examples of the intended expressions than the non-autistic expressions. In Study 3, we used a set of expressions created by autistic and non-autistic individuals who could see their faces as they made the expressions, which could allow them to explicitly match the expression they produced with their internal representation of that emotional expression. Here, neither autistic expressions nor non-autistic expressions were consistently recognized more accurately. In short, these findings suggest that differences in internal representations of what emotional expressions look like are unlikely to play a major role in explaining why non-autistic people sometimes misunderstand the emotions autistic people are experiencing.

Ambulatory digital phenotyping of blunted affect and alogia using objective facial and vocal analysis: Proof of concept.

Negative symptoms reflect one of the most debilitating aspects of one of the most debilitating diseases known to humankind. As yet, our treatments for negative symptoms are palliative at best and our understanding of their causes is relatively superficial. To address this, we are developing objective ambulatory tools for digitally phenotyping their severity which can be used outside the confines of the traditional clinical and research settings. The present study evaluated the feasibility, reliability and validity of ambulatory vocal acoustic and facial emotion expression analysis. Videos were provided by 25 patients with schizophrenia or schizoaffective disorder and 27 nonpsychiatric controls using inexpensive, non-invasive ambulatory recording methods. Controls provided 411 video recordings, and patients provided 377 video recordings; an average of 15.22 and 14.50 per participant per group respectively. The vast majority (over 80%) of these videos were usable for analysis. An empirically-supported, limited-feature vocal (7 features) and facial (3 features) set was examined. Within participants, these features varied considerably over time, but showed moderate to good test-retest reliability in many cases once contextual factors (e.g., activity involved in at the time of testing) were accounted for. Vocal and facial features showed statistically significant convergence with a "gold standard" negative symptom measure. Ambulatory vocal/facial features were more strongly associated with engagement in social or work activities in patients than negative symptom ratings. These data support the use of ambulatory vocal/facial analytic technologies for digital phenotyping of these negative symptoms.

Group Differences in Facial Emotion Expression in Autism: Evidence for the Utility of Machine Classification.

Effective social communication relies, in part, on accurate nonverbal expression of emotion. To evaluate the nature of facial emotion expression (FEE) deficits in children with autism spectrum disorder (ASD), we compared 20 youths with ASD to a sample of typically developing (TD) youth (n = 20) using a machine-based classifier of FEE. Results indicate group differences in FEE for overall accuracy across emotions. In particular, a significant group difference in accuracy of FEE was observed when participants were prompted by a video of a human expressing an emotion, F(2, 36) = 4.99, p = .032, η2 = .12. Specifically, youth with ASD made significantly more errors in FEE relative to TD youth. Findings support continued refinement of machine-based approaches to assess and potentially remediate FEE impairment in youth with ASD.

Task Dependency When Evaluating Association Between Facial Emotion Recognition and Facial Emotion Expression in Children with ASD.

The impact of facial emotion recognition (FER) deficits on facial emotion expression (FEE) during interaction with a novel computerized system was investigated in children with ASD (n = 20), in comparison to typically developing (TD) peers (n = 20). Although there was not clear evidence of impaired FEE, children with ASD showed more atypical FEE. In children with ASD, better FER predicted better FEE when the participants were asked to express a labeled emotion (t(18) = - 2.75, p = .01, d = 1.24). The stronger relationship between FER and FEE in children with ASD, relative to controls, suggests that intervention targeting social communication deficits might have maximal effect when both processes are considered.

Dynamic Facial Expression of Emotion and Observer Inference.

Research on facial emotion expression has mostly focused on emotion recognition, assuming that a small number of discrete emotions is elicited and expressed via prototypical facial muscle configurations as captured in still photographs. These are expected to be recognized by observers, presumably via template matching. In contrast, appraisal theories of emotion propose a more dynamic approach, suggesting that specific elements of facial expressions are directly produced by the result of certain appraisals and predicting the facial patterns to be expected for certain appraisal configurations. This approach has recently been extended to emotion perception, claiming that observers first infer individual appraisals and only then make categorical emotion judgments based on the estimated appraisal patterns, using inference rules. Here, we report two related studies to empirically investigate the facial action unit configurations that are used by actors to convey specific emotions in short affect bursts and to examine to what extent observers can infer a person's emotions from the predicted facial expression configurations. The results show that (1) professional actors use many of the predicted facial action unit patterns to enact systematically specified appraisal outcomes in a realistic scenario setting, and (2) naïve observers infer the respective emotions based on highly similar facial movement configurations with a degree of accuracy comparable to earlier research findings. Based on estimates of underlying appraisal criteria for the different emotions we conclude that the patterns of facial action units identified in this research correspond largely to prior predictions and encourage further research on appraisal-driven expression and inference.

Feasibility of Automated Training for Facial Emotion Expression and Recognition in Autism.

Impairment in facial emotion recognition (FER) and facial emotion expression (FEE), often documented in autism spectrum disorder (ASD), are believed to contribute to the observed core social-communication disability that characterizes this disorder. Moreover, impaired FER and FEE are frequently seen in other disorders and problem behaviors. We describe the development of a novel system to detect and give real-time feedback on these processes, termed facial emotion expression training (FEET), an automated, gamelike system that is based on 3-dimensional sensing (Kinect) technology. A sample of 40 children (n = 20 ASD, n = 20 typically developing) interacted with our prototype system, which presented audiovisual stimuli and assessed responses of participants. Overall, consumer satisfaction ratings were high, and youth with ASD reported enjoying interacting with the system more than did the typical youth. Results suggest that new technology-based interventions are acceptable to consumers and viable for use in remediation of transdiagnostic processes, such as FER and FEE. Implications for future technology-based intervention to target transdiagnostic processes are discussed.

BESST (Bochum Emotional Stimulus Set)--a pilot validation study of a stimulus set containing emotional bodies and faces from frontal and averted views.

This article introduces the freely available Bochum Emotional Stimulus Set (BESST), which contains pictures of bodies and faces depicting either a neutral expression or one of the six basic emotions (happiness, sadness, fear, anger, disgust, and surprise), presented from two different perspectives (0° frontal view vs. camera averted by 45° to the left). The set comprises 565 frontal view and 564 averted view pictures of real-life bodies with masked facial expressions and 560 frontal and 560 averted view faces which were synthetically created using the FaceGen 3.5 Modeller. All stimuli were validated in terms of categorization accuracy and the perceived naturalness of the expression. Additionally, each facial stimulus was morphed into three age versions (20/40/60 years). The results show high recognition of the intended facial expressions, even under speeded forced-choice conditions, as corresponds to common experimental settings. The average naturalness ratings for the stimuli range between medium and high.