Although several affective impairments have been demonstrated to occur following closed-head injury (CHI), deficits of the communicative function of language, particularly sentenial and suprasentential pragmatic aspects, have been suggested, but not demonstrated, to occur. This study compared 31 normals and 31 severely closed-head injured patients matched for age, sex and education. The dependent measures consisted of a facial test of emotion (FTE) and a contextual test of emotion (CTE). The former task consisted of 36 slides representing facial expressions of the six emotions demonstrated by Ekman and colleagues to be transcultural, namely, job, sadness, fear, anger, surprise and disgust. The subject was required to name the appropriate emotion for each slide. The latter task consisted of correctly identifying the appropriate emotion for each of 36 brief verbal narratives representing contexts connotative of the same six transcultural emotions. The CHI patients were impaired overall on the FTE but not the CTE. However, the ability to identify anger was significantly impaired on both tasks when considered in isolation from the other emotions. It was concluded that a processing deficit of primary emotional material, particularly anger, does exist following CHI, but that this deficit is not necessarily independent of task and/or modality parameters. It was also concluded that evidence of a pragmatic deficit of the language function following CHI remains to be provided at this time.

It is now known that closed head injury (CHI) impairs interpersonal skills, disturbs and/or blunts mood and compromises emotional discriminativeness. This study tried to test whether sense of humour is also impaired or disturbed following CHI. Subjects were 42 CHI patients and 42 normal controls, matched for age, education and paternal occupation. Humour performance measures included time taken to rank jokes according to funniness and to classify them, stability of funniness rankings at re-test and ability to correctly classify jokes into 'mutilated' and 'intact' categories. Non-performance measures included total number of non-verbal vocalizations, and mean percentage of appreciation of the jokes. The CHI patients were highly significantly impaired on all aspects of performance but did not differ from the normals on non-performance measures. However, when vocabulary (WAIS-R) was co-varied out of the analyses only time to rank funniness remained significant. The results were interpreted to suggest a severe impairment of sense of humour, an important cause of which is a narrow lexicon, poor lexical semantic processing, or some other reading dysfunction, some of which probably antedated the CHI. It was concluded that measures of humour, vocabulary, and of pure affective performance such as prosodic and/or facial emotion discrimination could contribute to the rehabilitation process in severe CHI.

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