Spontaneous and posed emotional facial expressions following severe traumatic brain injury

The current study aimed to test the intensity of spontaneous emotional expressions and the accuracy of posed emotional expressions in patients with severe traumatic brain injury (TBI).

Twenty-three participants with TBI and 27 matched control participants were asked to relate personal angry, happy, and sad events (spontaneous expressivity) and to pose angry, happy, and sad expressions in response to a photo or word cue (posed expressivity). Their emotional facial expressions were coded via judges' ratings.

Participants with TBI had less intense sad expressions when relating a sad event than did control participants. No group difference emerged in the happy and angry events, the latter possibly due to differentially low interrater reliability for anger ratings. Participants with TBI were impaired in their ability to pose sad emotions.

These preliminary findings suggest that patients with TBI are impaired at expressing sad expressions either spontaneously or deliberately. This may reflect difficulties in the initiation or suppression of facial expression as well as an impaired semantic knowledge of the facial configuration of sad expression.