Advertisement

Empathic Responses to Affective Film Clips Following Brain Injury and the Association With Emotion Recognition Accuracy

  • Dawn Neumann
    Correspondence
    Corresponding author Dawn Neumann, PhD, Indiana University School of Medicine, Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital of Indiana, 4141 Shore Drive, Indianapolis, IN 46254.
    Affiliations
    Indiana University School of Medicine, Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital of Indiana, Indianapolis, IN
    Search for articles by this author
  • Barbra Zupan
    Affiliations
    School of Health, Medical, and Applied Sciences, Department of Exercise and Health Sciences, Central Queensland University, Rockhampton, QLD, Australia
    Search for articles by this author
Published:August 22, 2018DOI:https://doi.org/10.1016/j.apmr.2018.07.431

      Abstract

      Objective

      To compare empathic responses to affective film clips in participants with traumatic brain injury (TBI) and controls, and examine associations with affect recognition.

      Design

      Cross sectional study using a quasi-experimental design.

      Setting

      Multi-site study conducted at a postacute rehabilitation facility in the United States and a university in Canada.

      Participants

      Adults (N=120) with moderate to severe TBI (n=60) and those without TBI (n=60), frequency matched for age and sex. Average time postinjury was 14 years (range: .5-37).

      Main Outcome Measures

      Participants were shown affective film clips and asked to report how the main character in the clip felt and how they personally felt in response to the clip. Empathic responses were operationalized as participants feeling the same emotion they identified the character to be feeling.

      Results

      Participants with TBI had lower emotion recognition scores (P=.007) and fewer empathic responses than controls (67% vs 79%; P<.001). Participants with TBI accurately identified and empathically responded to characters’ emotions less frequently (65%) than controls (78%). Participants with TBI had poorer recognition scores and fewer empathic responses to sad and fearful clips compared to controls. Affect recognition was associated with empathic responses in both groups (P<.001). When participants with TBI accurately recognized characters’ emotions, they had an empathic response 71% of the time, which was more than double their empathic responses for incorrectly identified emotions.

      Conclusions

      Participants with TBI were less likely to recognize and respond empathically to others’ expressions of sadness and fear, which has implications for interpersonal interactions and relationships. This is the first study in the TBI population to demonstrate a direct association between an affect stimulus and an empathic response.

      Keywords

      List of abbreviations:

      TBI (traumatic brain injury)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • May M.
        • Milders M.
        • Downey B.
        • et al.
        Social behavior and impairments in social cognition following traumatic brain injury.
        J Int Neuropsychol Soc. 2017; 23: 400-411
        • Neumann D.
        • Zupan B.
        • Malec J.
        • Hammond F.
        Relationships between alexithymia, affect recognition, and empathy after traumatic brain injury.
        J Head Trauma Rehabil. 2014; 29: E18-E27
        • Shamay-Tsoory S.G.
        • Tomer R.
        • Berger B.D.
        • Aharon-Peretz J.
        Characterization of empathy deficits following prefrontal brain damage: the role of the right ventromedial prefrontal cortex.
        J Cogn Neurosci. 2003; 15: 324-337
        • Nowicki S.
        • Duke M.P.
        Individual differences in the nonverbal communication of affect: the diagnostic analysis of nonverbal accuracy scale.
        J Nonverbal Behavior. 1994; 18: 9-35
        • Davis M.H.
        Measuring individual differences in empathy: evidence for a multidimensional approach.
        J Personality Soc Psychol. 1983; 44: 113-126
        • Babbage D.R.
        • Yim J.
        • Zupan B.
        • Neumann D.
        • Tomita M.R.
        • Willer B.
        Meta-analysis of facial affect recognition difficulties after traumatic brain injury.
        Neuropsychology. 2011; 25: 277-285
        • Bornhofen C.
        • McDonald S.
        Emotion perception deficits following traumatic brain injury: a review of the evidence and rationale for intervention.
        J Int Neuropsychol Soc. 2008; 14: 511-525
        • de Sousa A.
        • McDonald S.
        • Rushby J.
        • Li S.
        • Dimoska A.
        • James C.
        Why don't you feel how I feel? Insight into the absence of empathy after severe traumatic brain injury.
        Neuropsychologia. 2010; 48: 3585-3595
        • de Sousa A.
        • McDonald S.
        • Rushby J.
        • Li S.
        • Dimoska A.
        • James C.
        Understanding deficits in empathy after traumatic brain injury: the role of affective responsivity.
        Cortex. 2011; 47: 526-535
        • Shamay-Tsoory S.G.
        • Tomer R.
        • Goldsher D.
        • Berger B.D.
        • Aharon-Peretz J.
        Impairment in cognitive and affective empathy in patients with brain lesions: anatomical and cognitive correlates.
        J Clin Exp Neuropsychol. 2004; 26: 1113-1127
        • Wood R.L.
        • Williams C.
        Inability to empathize following traumatic brain injury.
        J Int Neuropsychol Soc. 2008; 14: 289-296
        • Adolphs R.
        Recognizing emotion from facial expressions: psychological and neurological mechanisms.
        Behav Cogn Neurosci Rev. 2002; 1: 21-62
        • Neumann D.
        • Keiski M.A.
        • McDonald B.C.
        • Wang Y.
        Neuroimaging and facial affect processing: implications for traumatic brain injury.
        Brain Imaging Behav. 2014; 8: 460-473
        • Bastiaansen J.
        • Thioux M.
        • Keysers C.
        Evidence for mirror systems in emotions.
        Philos Trans R Soc Lond B Biol Sci. 2009; 364: 2391-2404
        • Carr M.B.
        • Lutjemeier J.A.
        The relation of facial affect recognition and empathy to delinquency in youth offenders.
        Adolescence. 2005; 40: 601-619
        • Iacoboni M.
        • Mazziotta J.C.
        Mirror neuron system: basic findings and clinical applications.
        Ann Neurol. 2007; 62: 213-218
        • Woods S.
        • Wolke D.
        • Nowicki S.
        • Hall L.
        Emotion recognition abilities and empathy of victims of bullying.
        Child Abuse Negl. 2009; 33: 307-311
        • Seidel E.M.
        • Pfabigan D.M.
        • Keckeis K.
        • et al.
        Empathic competencies in violent offenders.
        Psychiatry Res. 2013; 210: 1168-1175
        • Besel L.D.
        • Yuille J.C.
        Individual differences in empathy: the role of facial expression recognition.
        Pers Indiv Dif. 2010; 49: 107-112
        • Yirmiya N.
        • Sigman M.D.
        • Kasari C.
        • Mundy P.
        Empathy and cognition in high-functioning children with autism.
        Child Dev. 1992; 63: 150-160
        • Feshbach N.D.
        Sex differences in empathy and social behavior in children.
        in: Eisenberg N. The development of prosocial behavior. Academic Press, New York1982: 315-338
        • Hopkins M.J.
        • Dywan J.
        • Segalowitz S.J.
        Altered electrodermal response to facial expression after closed head injury.
        Brain Inj. 2002; 16: 245-257
        • Neumann D.R.
        • Hammond F.
        • Norton J.
        • Blumenthal T.
        Using startle to objectively measure anger and other emotional responses after traumatic brain injury: a pilot study.
        J Head Trauma Rehabil. 2011; 26: 375-383
        • Zupan B.
        • Neumann D.
        Affect recognition in traumatic brain injury: responses to unimodal and multimodal media.
        J Head Trauma Rehabil. 2014; 29: E1-E12
        • Phillips M.L.
        • Drevets W.C.
        • Rauch S.L.
        • Lane R.
        Neurobiology of emotion perception I: the neural basis of normal emotion perception.
        BiolPsychiatry. 2003; 54: 504-514
        • Saunders J.C.
        • McDonald S.
        • Richardson R.
        Loss of emotional experience after traumatic brain injury: findings with the startle probe procedure.
        Neuropsychology. 2006; 20: 224-231
        • Spell L.A.
        • Frank E.
        Recognition of nonverbal communication of affect following traumatic brain injury.
        J Nonverbal Behavior. 2000; 24: 285-300
        • Malec J.F.
        • Brown A.W.
        • Leibson C.L.
        • et al.
        The Mayo classification system for traumatic brain injury severity.
        J Neurotrauma. 2007; 24: 1417-1424
        • Zupan B.
        • Babbage D.R.
        Film clips and narrative text as subjective emotion elicitation techniques.
        J Soc Psychol. 2017; 157: 194-210
        • Radice-Neumann D.
        • Zupan B.
        • Babbage D.R.
        • Willer B.
        Overview of impaired facial affect recognition in persons with traumatic brain injury.
        Brain Inj. 2007; 21: 807-816
        • Neumann D.
        • Babbage D.R.
        • Zupan B.
        • Willer B.
        A randomized controlled trial of emotion recognition training after traumatic brain injury.
        J Head Trauma Rehabil. 2015; 30: E12-E23
        • Radice-Neumann D.
        • Zupan B.
        • Tomita M.
        • Willer B.
        Training emotional processing in persons with brain injury.
        J Head Trauma Rehabil. 2009; 24: 313-323
        • Spikman J.M.
        • Milders M.V.
        • Visser-Keizer A.C.
        • Westerhof-Evers H.J.
        • Herben-Dekker M.
        • van der Naalt J.
        Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury.
        PLoS One. 2013; 8e65581
        • Westerhof-Evers H.J.
        • Visser-Keizer A.C.
        • Fasotti L.
        • et al.
        Effectiveness of a treatment for impairments in social cognition and emotion regulation (T-ScEmo) after traumatic brain injury: a randomized controlled trial.
        J Head Trauma Rehabil. 2017; 32: 296-307