Related Experiment Video
Updated: Jun 5, 2026
Exploring the Use of Isolated Expressions and Film Clips to Evaluate Emotion Recognition by People with Traumatic Brain Injury
Published on: May 15, 2016
Using startle to objectively measure anger and other emotional responses after traumatic brain injury: a pilot study
Dawn Radice Neumann1, Flora Hammond, James Norton
1Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Carolinas HealthCare System, Charlotte, North Carolina 28203, USA. dmneuman@iupui.edu
Objective:
To determine the effectiveness of a modulated acoustic startle reflex paradigm with emotional imagery in studying physiological changes associated with emotional responses in persons with traumatic brain injury (TBI).
Setting:
Outpatient rehabilitation hospital.
Participants:
Six individuals with moderate to severe TBI. Mean age was 32 years and mean years postinjury were 9.9.
Method:
The modulated acoustic startle reflex procedure involved imagery of emotional scripts (joy, anger, fear, and neutral) followed by a startle noise, versus startle noise alone (no script).
Measures:
Eyeblink and skin conductance response, subjective arousal and valence ratings of the scripts, and general anger questionnaire.
Results:
Startle blink responses following anger imagery were significantly smaller than those following fear (P = .006) and neutral (P = .023) imagery. Skin conductance response did not change significantly based on the content of the scripts (P = .070).
Conclusions:
Large startle blink responses indicate avoidance of a stimulus. Our findings suggest that participants with TBI did not have an avoidant reaction to anger-inducing stimuli. Skin conductance response findings may imply arousal impairments. The modulated acoustic startle reflex was effective in measuring emotional responses; however, larger studies comparing persons with TBI with control groups are needed to further explore these findings.
