Behaviors of Concern after Acquired Brain Injury: The Role of Negative Emotion Recognition and Anger Misattribution

Abstract

Objective: Behavioral changes are common after acquired brain injury (ABI) and may be caused by social cognition impairments. We investigated whether impaired emotion recognition, specifically Negative Emotion Recognition (NER) and Anger Misattribution (AM), after ABI was related to behavioral problems, so-called Behaviors of Concern (BoC). Method: The study included 139 participants with ABI and 129 healthy controls. BoC was measured using four scales of the Brock Adaptive Functioning Questionnaire (BAFQ): Impulsivity, Aggression, Social Monitoring, and Empathy. Both self-ratings and informant ratings of BoC were obtained. Emotion recognition was measured with the Ekman 60 Faces Test (FEEST). A NER score was composed of the summed scores on Anger, Disgust, Fear, and Sadness. An AM score was composed of the number of facial expressions wrongly recognized as Anger. Results: Total FEEST scores in ABI participants were significantly worse than in healthy controls. The effect size is moderate. Informants rated significantly more problems in Social Monitoring and Empathy than participants. Effect sizes were small. Scores on FEEST total, NER, and AM were significantly correlated to informant ratings of Social Monitoring. Correlations were weak to moderate. Conclusions: Worse NER and more profound AM were related to more informant-rated problems in social monitoring. In addition, informants rated more problems in social monitoring and empathy than participants. This strongly suggests problems in self-awareness in ABI participants. Consequently, social cognition tests and informant ratings should be used in clinical practice to improve the detection and treatment of BoC after ABI.

Measuring emotion recognition: Added value in diagnosing dementia of the Alzheimer’s disease type

“…Therefore, following up on Jorna et al. (2021) who reported on impaired NER in ABI patients, we additionally performed the logistic regression analysis with only negative emotions (NER) as a predictor variable. However, NER did not significantly differentiate between diagnostic categories, whereas overall emotion recognition performance, pertaining to aggregated score on the whole range of emotional expressions, did.…”

“…However, in another study the recognition of disgust was impaired in AD patients, but preserved in MCI patients (Bediou et al., 2009). Specific impairments in NER were found to be associated with an increase in social behavioural problems in patients with acquired brain injury (ABI), as reported by informal caregivers (Jorna et al., 2021). Regarding MDD, in one meta‐analysis impaired recognition of the emotions anger, disgust, fear, happiness, and surprise was reported and no impairments in sadness (Dalili et al., 2015).…”

Behavioural Data in Credibility Assessment: Case Study of Kaja Godek’s Explanatory Statement of Anti-LGBT Law

“…Therefore, recipients (often unaware) search for indicators of honesty to separate reliable and unreliable sources. It expands the importance of behaviour assessment and non-verbal communication -even knowing that Albert Mehrabian overestimated the significance of facial channel in the overall impact of a message (Hegstrom, 1979;Mehrabian, Wiener, 1967;Mehrabian, Ferris, 1967), we agree that our cognition is oriented towards encoding facial expressions (Noah et al, 2020;Borod et al, 2002;Dailey et al, 2002;Jorna et al, 2021) and non-verbal messages mediate commitment towards communication (Asan et al, 2015).…”

Impaired Emotion Recognition: A Potential Marker for Social Behavioral Problems in Patients With Amnestic Mild Cognitive Impairment and Early Alzheimer Disease?

“…1 In patient groups with acquired and traumatic brain injuries, inappropriate disinhibited social behavior and decreased social monitoring, as rated by close others, have indeed been found to be related to impaired emotion recognition. 10,17 Only a few studies investigated possible relations between specific "behaviors of concern" reported by proxies and impaired emotion recognition in AD dementia. 18 Poveda et al (2017) 19 found no associations among indices of apathy, agitation, irritability, and impaired emotion recognition.…”

“…A more direct relation between increased aggressive and disinhibited behaviors, considered as problematic by close others, and impaired emotion recognition can be explained by patients not being able to perceive the emotional expressions of their close others, such as looking sad, frowning or being angry, which can be considered as stop signals for these behaviors 1 . In patient groups with acquired and traumatic brain injuries, inappropriate disinhibited social behavior and decreased social monitoring, as rated by close others, have indeed been found to be related to impaired emotion recognition 10,17 …”