Preferential processing of threatening facial expressions using the repetition blindness paradigm.

BACKGROUND: Neuroanatomical evidence suggests that the human brain has dedicated pathways to rapidly process threatening stimuli. This processing bias for threat was examined using the repetition blindness (RB) paradigm. RB (i.e., failure to report the second instance of an identical stimulus rapidly following the first) has been established for words, objects and faces but not, to date, facial expressions. METHODS: 78 (Study 1) and 62 (Study 2) participants identified repeated and different, threatening and non-threatening emotional facial expressions in rapid serial visual presentation (RSVP) streams. RESULTS: In Study 1, repeated facial expressions produced more RB than different expressions. RB was attenuated for threatening expressions. In Study 2, attenuation of RB for threatening expressions was replicated. Additionally, semantically related but non-identical threatening expressions reduced RB relative to non-threatening stimuli. CONCLUSIONS: These findings suggest that the threat bias is apparent in the temporal processing of facial expressions, and expands the RB paradigm by demonstrating that identical facial expressions are susceptible to the effect.

Angry responses to emotional events: the role of impaired control and drive in people with severe traumatic brain injury.

Emotional and behavioral changes (e.g., irritability and anger or alternatively passivity and inertia) are common after traumatic brain injury (TBI). These changes have been conceptualized as reflecting a loss of regulation, specifically control (loss of inhibition) and/or drive (self-initiation). However, no empirical studies have examined the relationship between neuropsychological measures of these constructs and emotional responsivity in situ. In this study, 29 individuals with severe, chronic TBI and 32 matched control participants were shown emotionally evocative films selected to elicit anger and were asked to rate their emotions before and after. They were also given measures of executive function to assess inhibition and flexibility as indices of control and drive, respectively. Both groups had heightened anxiety after the films. An increase in anger and confusion correlated with impaired control (Haylings Test score, Trails B errors) in the TBI group but not in controls. No association was found between reduced emotional responsivity and drive (Controlled Oral Word Association Test, Matrix Reasoning Scaled Score, Trails A/B time difference). This study provides support for the use of formal measures of disinhibition on neuropsychological tests as a corollary for emotion disinhibition. As with previous work, operationalization of loss of drive was more difficult to achieve.

Addressing deficits in emotion recognition after severe traumatic brain injury: the role of focused attention and mimicry.

Deficits in emotion perception are prevalent in people with severe traumatic brain injury (TBI) and are an important target for remediation. Preliminary work has indicated that emotion perception can improve with treatment but there is a dearth of studies examining the efficacy of specific techniques. In this study we examined two remediation strategies: (1) focusing attention on relevant aspects of the facial expression, and (2) mimicking the facial expression. Twenty-two people with chronic, severe brain injuries and 32 people matched on basic demographic variables were asked to label six basic emotions spontaneously followed by either a Focus or Mimic instructional strategy. Contrary to expectations, the TBI group was not poorer than the control group in the Spontaneous condition. Consequently, the effects of Focus vs. Mimic were examined for participants who had average scores or less in the Spontaneous condition (n = 14 and 20, respectively). The poorer performing control group was found to benefit from repeated exposure regardless of remediation strategy. The TBI group did not. Over and above repeated exposure, the Focus instruction assisted control participants but lead to poorer performance in those with TBI. The Mimic strategy resulted in little improvement for either group. Those who benefited least from the Focus strategies in the TBI group were those with poor abstract reasoning and flexibility. There was no such association in the control group and no associations between cognitive abilities and changes in scores using the Mimic strategy in either group.

Social skills treatment for people with severe, chronic acquired brain injuries: a multicenter trial.

OBJECTIVE: To determine whether social skills deficits including unskilled, inappropriate behavior, problems reading social cues (social perception), and mood disturbances (such as depression and anxiety) could be remediated after severe traumatic brain injuries. DESIGN: Randomized controlled trial comparing a social skills program with social activity alone or with waitlist control. Several participants were reassigned after randomization. SETTING: Hospital outpatient and community facilities. PARTICIPANTS: Fifty-one outpatients from 3 brain injury units in Sydney, Australia, with severe, chronic acquired brain injuries were recruited. A total of 39 people (13 in skills training, 13 in social activity, 13 in waitlist) completed all phases of the study. INTERVENTION: Twelve-week social skills treatment program encompassing weekly 3-hour group sessions focused on shaping social behavior and remediating social perception and 1-hour individual sessions to address psychologic issues with mood, self-esteem, etc. MAIN OUTCOME MEASURES: Primary outcomes were: (1) social behavior during encounters with a confederate as rated on the Behaviorally Referenced Rating System of Intermediary Social Skills-Revised (BRISS-R), (2) social perception as measured by The Awareness of Social Inference Test, and (3) depression and anxiety as measured by the Depression, Anxiety and Stress Scale. Secondary outcomes were: relative report on social behavior and participation using: the Katz Adjustment Scale-R1; the Social Performance Survey Schedule; the La Trobe Communication Questionnaire; and the Sydney Psychosocial Reintegration Scale (both relative and self-report). RESULTS: Repeated-measures analysis of variance indicated that social activity alone did not lead to improved performance relative to waitlist (placebo effect) on any outcome variable. On the other hand, the skills training group improved differentially on the Partner Directed Behavior Scale of the BRISS-R, specifically the self-centered behavior and partner involvement behavior subscales. No treatment effects were found for the remaining primary outcomes (social perception, emotional adjustment) or for secondary outcome variables (relative and self-report measures of social function). CONCLUSIONS: This study suggested that treatment effects after social skills training in people with severe, chronic brain injuries are modest and are limited to direct measures of social behavior.

Emotion perception deficits following traumatic brain injury: a review of the evidence and rationale for intervention.

While the cognitive disturbances that frequently follow severe traumatic brain injury (TBI) are relatively well understood, the ways in which these affect the psychosocial functioning of people with TBI are yet to be determined and have thus received little attention in treatment research. Growing evidence indicates that a significant proportion of individuals with TBI demonstrate an inability to recognize affective information from the face, voice, bodily movement, and posture. Because accurate interpretation of emotion in others is critical for the successful negotiation of social interactions, effective treatments are necessary. Until recently, however, there have been no rehabilitation efforts in this area. The present review examines the literature on emotion perception deficits in TBI and presents a theoretical rationale for targeted intervention. Several lines of research relevant to the remediation of emotion perception in people with TBI are considered. These include work on emotion perception remediation with other cognitively impaired populations, current neuropsychological models of emotion perception and underlying neural systems, and recent conceptualizations of remediation processes. The article concludes with a discussion of the importance of carrying out efforts to improve emotion perception within a contextualized framework in which the day-to-day relevance of training is clear to all recipients.

Comparing strategies for treating emotion perception deficits in traumatic brain injury.

OBJECTIVE: To compare the efficacy of 2 strategies, errorless learning (EL) and self-instruction training (SIT), for remediating emotion perception deficits in individuals with traumatic brain injury (TBI). DESIGN: Randomized controlled trial comparing groups receiving 25 hours (across 10 weeks) of treatment with either EL or SIT with waitlist control. SETTING AND PARTICIPANTS: Eighteen adult outpatient volunteers with severe TBI who were at least 6 months postinjury. MAIN OUTCOMES MEASURES: Photograph-based emotion recognition tasks, The Awareness of Social Inferences Test, and questionnaire measures, for example, the Sydney Psychosocial Reintegration Scale. RESULTS: Both treatment groups showed modest improvement in emotion perception ability. Limited evidence suggests that SIT may be a favorable approach for this type of remediation. CONCLUSIONS: Although further research is needed, there are reasons for optimism regarding rehabilitation of emotion perception following TBI.

Treating deficits in emotion perception following traumatic brain injury.

The present research aimed to investigate whether social perception deficits commonly experienced in the adult traumatic brain injury (TBI) population can be successfully remediated through cognitive rehabilitation. Twelve outpatient volunteers (11 male, 1 female; age range 20-57 years) with severe, chronic TBI (mean length of post-traumatic amnesia 121 days, range 58-210 days; mean months post- injury 93.58, range 17-207 months) participated in a randomised controlled trial. Participants were randomly allocated to treatment and waitlist control groups following assessment on a range of emotion perception and psychosocial measures. Treatment comprised 25 hours, across 8 weeks, of a programme specifically designed to address emotion perception which incorporated a variety of remediation techniques shown to be effective with the TBI population. Results indicated that participants significantly improved both in judging basic emotional stimuli when presented in a naturalistic format (i.e., video vignettes) and in making social inferences on the basis of speaker demeanour. This is the first known treatment study dealing with emotion perception deficits in individuals with TBI.

Reliability and validity of The Awareness of Social Inference Test (TASIT): a clinical test of social perception.

PURPOSE: The Awareness of Social Inference Test (TASIT) is an audiovisual tool designed for the clinical assessment of social perception with alternate forms for re-testing. Part 1 assesses emotion recognition, Parts 2 and 3 assess the ability to interpret conversational remarks meant literally (i.e., sincere remarks and lies) or non-literally (i.e., sarcasm) as well as the ability to make judgments about the thoughts, intentions and feelings of speakers. This paper aims to examine TASIT's reliability and validity. METHOD: Some 32 adults with severe, chronic brain injuries were administered Form A twice, one week apart. 38 adults with brain injuries were readministered alternate forms over a period of 5 - 26 weeks. Construct validity was examined in subsets of a sample of 116 adults with brain injuries by relating TASIT performance to standard tests of neuropsychological function and specific social perception measures. RESULTS: Test-retest reliability ranged from 0.74 - 0.88. Alternate forms reliability ranged from 0.62 - 0.83. TASIT performance was associated with face perception, information processing speed and working memory. Socially relevant new learning and executive tasks were significantly associated with TASIT performance whereas non-social tasks showed little association. Social perception tasks such as Ekman photos and theory of mind stories were also associated. CONCLUSIONS: TASIT has adequate psychometric properties as a clinical test of social perception. It is not overly prone to practice effects and is reliable for repeat administrations. Performance on TASIT is affected by information processing speed, working memory, new learning and executive functioning, but the uniquely social material that comprises the stimuli for TASIT will provide useful insights into the particular difficulties people with clinical conditions experience when interpreting complex social phenomena.