Research Reports - Emotional expression and socially modulated emotive communication in children with traumatic brain injury

J Int Neuropsychol Soc. 2013 Jan;19(1):34-43

Dennis M, Agostino A, Taylor HG, Bigler ED, Rubin K, Vannatta K, Gerhardt CA, Stancin T, Yeates KO

Facial emotion expresses feelings, but is also a vehicle for social
communication. Using five basic emotions (happiness, sadness, fear, disgust, and
anger) in a comprehension paradigm, we studied how facial expression reflects
inner feelings (emotional expression) but may be socially modulated to
communicate a different emotion from the inner feeling (emotive communication, a
form of affective theory of mind). Participants were 8- to 12-year-old children
with TBI (n = 78) and peers with orthopedic injuries (n = 56). Children with
mild-moderate or severe TBI performed more poorly than the OI group, and chose
less cognitively sophisticated strategies for emotive communication. Compared to
the OI and mild-moderate TBI groups, children with severe TBI had more deficits
in anger, fear, and sadness; neutralized emotions less often; produced socially
inappropriate responses; and failed to differentiate the core emotional dimension
of arousal. Children with TBI have difficulty understanding the dual role of
facial emotions in expressing feelings and communicating socially relevant but
deceptive emotions, and these difficulties likely contribute to their social

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