To Fear is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls

Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear

Young Offenders’ Emotion Recognition Dysfunction Across Emotion Intensities: Explaining Variation Using Psychopathic Traits, Conduct Disorder and Offense Severity

Antisocial individuals have problems recognizing negative emotions (e.g. Marsh & Blair in Neuroscience and Biobehavioral Reviews 32:454–465, 2009); however, due to issues with sampling and different methods used, previous findings have been varied. Sixty-three male young offenders and 37 age-, IQ- and socio-economic status-matched male controls completed a facial emotion recognition task, which measures recognition of happiness, sadness, fear, anger, disgust, and surprise and neutral expressions across 4 emotional intensities. Conduct disorder (YSR), and psychopathic and callous/unemotional traits (YPI) were measured, and offenders’ offense data were taken from the Youth Offending Service’s case files. Relative to controls, offenders were significantly worse at identifying sadness, low intensity disgust and high intensity fear. A significant interaction for anger was also observed, with offenders showing reduced low- but increased high-intensity anger recognition in comparison with controls. Within the young offenders levels of conduct disorder and psychopathic traits explained variation in sadness and disgust recognition, whereas offense severity explained variation in anger recognition. These results suggest that antisocial youths show specific problems in recognizing negative emotions and support the use of targeted emotion recognition interventions for problematic behavior

Training emotional processing in persons with brain injury

Zupan, BA ORCiD: 0000-0002-4603-333XAIMS: To determine the effectiveness of 2 interventions for different aspects of emotion-processing deficits in adults with acquired brain injury (ABI). PARTICIPANTS: Nineteen participants with ABI (minimum 1 year postinjury) from Western New York and Southern Ontario, Canada. INTERVENTIONS: (1) Emotion processing from faces ("facial affect recognition" or FAR) and (2) emotion processing from written context by using "stories of emotional inference" (SEI). Ten randomly assigned participants received the FAR intervention, and 9 received the SEI protocol. Both interventions were administered 1 hour per day, 3 times per week, and completed in 6 to 9 sessions, and both incorporated participants personal emotional experiences into training. OUTCOME MEASURES: (1) Facial affect, (2) vocal affect, (3) affect from videos, (4) emotional inference from context, and (5) emotional behavior. There were 2 pretests, a posttest, and a 2-week follow-up. RESULTS: FAR participants showed significantly improved emotion recognition from faces, ability to infer emotions from context, and socioemotional behavior, while the SEI group members exhibited significantly improved ability to infer how they would feel in a given context. CONCLUSION: Training can improve emotion perception in persons with ABI. Although further research is needed, the interventions are clinically practical and show promise for the population with ABI. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Training emotional processing in persons with brain injury

AIMS: To determine the effectiveness of 2 interventions for different aspects of emotion-processing deficits in adults with acquired brain injury (ABI). PARTICIPANTS: Nineteen participants with ABI (minimum 1 year postinjury) from Western New York and Southern Ontario, Canada. INTERVENTIONS: (1) Emotion processing from faces ("facial affect recognition" or FAR) and (2) emotion processing from written context by using "stories of emotional inference" (SEI). Ten randomly assigned participants received the FAR intervention, and 9 received the SEI protocol. Both interventions were administered 1 hour per day, 3 times per week, and completed in 6 to 9 sessions, and both incorporated participants personal emotional experiences into training. OUTCOME MEASURES: (1) Facial affect, (2) vocal affect, (3) affect from videos, (4) emotional inference from context, and (5) emotional behavior. There were 2 pretests, a posttest, and a 2-week follow-up. RESULTS: FAR participants showed significantly improved emotion recognition from faces, ability to infer emotions from context, and socioemotional behavior, while the SEI group members exhibited significantly improved ability to infer how they would feel in a given context. CONCLUSION: Training can improve emotion perception in persons with ABI. Although further research is needed, the interventions are clinically practical and show promise for the population with ABI. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Overview of impaired facial affect recognition in persons with traumatic brain injury

Primary objective: To review the literature of affect recognition for persons with traumatic brain injury (TBI). It is suggested that impairment of affect recognition could be a significant problem for the TBI population and treatment strategies are recommended based on research for persons with autism. Main outcomes and results: Research demonstrates that persons with TBI often have difficulty determining emotion from facial expressions. Studies show that poor i nterpersonal skills, which are associated with impaired affect recognition, are linked to a variety of negative outcomes. Theories suggest that facial affect recognition is achieved by interpreting important facial features and processing one's own emotions. These skills are often affected by TBI, depending on the areas damaged. Affect recognition impairments have also been identified in persons with autism. Successful interventions have already been developed for the autism population. Comparable neuroanatomical and behavioural findings between TBI and autism suggest that treatment approaches for autism may also benefit those with TBI. Conclusions: Impaired facial affect recognition appears to be a significant problem for persons with TBI. Theories of affect recognition, strategies used in autism and teaching techniques commonly used in TBI need to be considered when developing treatments to improve affect recognition in persons with brain injury