Effectiveness of a short audiovisual emotion recognition training program in adults

Gender and Accuracy in Decoding Affect Cues: A Meta-Analysis

Gender differences in understanding the meanings of affect cues, often labeled emotion recognition, have been studied for over a century. Past reviews of the literature have concluded that girls and women score higher than boys and men on tests of accuracy in decoding affect cues, which are most often tested in the cue modalities of face, body, and content-free voice. The present meta-analysis updates knowledge on this topic by including many more studies (1188 effect sizes in 1011 studies; total N = 837,637) and examining a wide range of moderators such as health status of sample, international location, cue channels of the test, and other sample and test characteristics. Indeed, the gender difference favoring girls and women still exists, and evidence for publication bias was weak. The difference is not large (r = 0.12, d = 0.24), but it is extremely consistent across many moderators, which, even when significant, show minor differences. Health status was the only moderator to produce groups without a significant gender difference.

Exploring Actual and Presumed Links between Accurately Inferring Contents of Other People's Minds and Prosocial Outcomes

The term "empathic accuracy" has been applied to people's ability to infer the contents of other people's minds-that is, other people's varying feelings and/or thoughts over the course of a social interaction. However, despite the ease of intuitively linking this skill to competence in helping professions such as counseling, the "empathic" prefix in its name may have contributed to overestimating its association with prosocial traits and behaviors. Accuracy in reading others' thoughts and feelings, like many other skills, can be used toward prosocial-but also malevolent or morally neutral-ends. Prosocial intentions can direct attention towards other people's thoughts and feelings, which may, in turn, increase accuracy in inferring those thoughts and feelings, but attention to others' thoughts and feelings does not necessarily heighten prosocial intentions, let alone outcomes.

Trainee psychotherapists' emotion recognition accuracy during 1.5 years of psychotherapy education compared to a control group: no improvement after psychotherapy training

The ability to recognize and work with patients' emotions is considered an important part of most psychotherapy approaches. Surprisingly, there is little systematic research on psychotherapists' ability to recognize other people's emotional expressions. In this study, we compared trainee psychotherapists' nonverbal emotion recognition accuracy to a control group of undergraduate students at two time points: at the beginning and at the end of one and a half years of theoretical and practical psychotherapy training. Emotion recognition accuracy (ERA) was assessed using two standardized computer tasks, one for recognition of dynamic multimodal (facial, bodily, vocal) expressions and one for recognition of facial micro expressions. Initially, 154 participants enrolled in the study, 72 also took part in the follow-up. The trainee psychotherapists were moderately better at recognizing multimodal expressions, and slightly better at recognizing facial micro expressions, than the control group at the first test occasion. However, mixed multilevel modeling indicated that the ERA change trajectories for the two groups differed significantly. While the control group improved in their ability to recognize multimodal emotional expressions from pretest to follow-up, the trainee psychotherapists did not. Both groups improved their micro expression recognition accuracy, but the slope for the control group was significantly steeper than the trainee psychotherapists'. These results suggest that psychotherapy education and clinical training do not always contribute to improved emotion recognition accuracy beyond what could be expected due to time or other factors. Possible reasons for that finding as well as implications for the psychotherapy education are discussed.

Association of emotion recognition ability and interpersonal emotional competence in anorexia nervosa: A study with a multimodal dynamic task

OBJECTIVE

Interpersonal difficulties are evidenced in Anorexia Nervosa (AN) and are thought to contribute to disease onset and maintenance, however, research in the framework of emotional competence is currently limited. Previous studies have often only used static images for emotion recognition tasks, and evidence is lacking on the relationships between performance-based emotional abilities and self-reported intra- and interpersonal emotional traits. This study aimed to test multimodal dynamic emotion recognition ability in AN and analyze its correlation with the psychometric scores of self- and other-related emotional competence.

METHOD

A total of 268 participants (128 individuals with AN and 140 healthy controls) completed the Geneva Emotion Recognition Test, the Profile of Emotional Competence, the Reading the Mind in the Eyes Test, and measures of general and eating psychopathology. Scores were compared between the two groups. Linear mixed effects models were utilized to examine the relationship between emotion recognition ability and self-reported measures and clinical variables.

RESULTS

Individuals with AN showed significantly poorer recognition of emotions of both negative and positive valence and significantly lower scores in all emotional competence dimensions. Beside emotion type and group, linear mixed models evidenced significant effects of interpersonal comprehension on emotion recognition ability.

DISCUSSION

Individuals with AN show impairment in multimodal emotion recognition and report their difficulties accordingly. Notably, among all emotional competence dimensions, interpersonal comprehension emerges as a significant correlate to emotion recognition in others, and could represent a specific area of intervention in the treatment of individuals with AN.

PUBLIC SIGNIFICANCE

In this study, we evidence that the ability to recognize the emotions displayed by others is related to the level of interpersonal emotional competence reported by individuals with anorexia nervosa. This result helps in understanding the social impairments in people with anorexia nervosa and could contribute to advancements in the application of the training of emotional competence in the treatment of this disorder.

Determinants of Social Cognitive Aging: Predicting Resilience and Risk

This review focuses on conceptual and empirical research on determinants of social cognitive aging. We present an integrated model [the social cognitive resource (SCoRe) framework] to organize the literature and describe how social cognitive resilience is determined jointly by capacity and motivational resources. We discuss how neurobiological aging, driven by genetic and environmental influences, is associated with broader sensory, neural, and physiological changes that are direct determinants of capacity as well as indirect determinants of motivation via their influence on expectation of loss versus reward and cognitive effort valuation. Research is reviewed that shows how contextual factors, such as relationship status, familiarity, and practice, are fundamental to understanding the availability of both types of resource. We conclude with a discussion of the implications of social cognitive change in late adulthood for everyday social functioning and with recommendations for future research.

Physicians, emotion, and the clinical encounter: A survey of physicians' experiences

OBJECTIVES

Training in emotion management is not a standard part of medical education. This study's objective was to understand physicians' challenges navigating emotion (their own and their patients') and identify areas for intervention to support physician wellness and enhance patient care.

METHODS

In 2019, we surveyed 103 physicians in emergency medicine, internal medicine, family medicine, and neurology. Participants quantitatively reported emotion training, emotions that were challenging, and barriers to addressing emotion. They provided qualitative examples of emotion challenges and successes that we analyzed using an inductive thematic analysis.

RESULTS

There were no significant differences in responses by specialty. Only 10% reported receiving emotion management training, with no evidence that more recently trained physicians received more. Those who had received training on emotion reported greater comfort in dealing with patients' emotions and were more likely to engage in teaching on emotion. There were gender and career stage differences regarding which emotions physicians found most challenging. The authors identified central themes of emotion-related challenges and successes.

CONCLUSIONS

Targeted educational initiatives are needed to advance physicians' ability to navigate emotion in clinical encounters.

PRACTICE IMPLICATIONS

Developing strategies for managing patients' emotions may better prepare physicians for navigating the emotional demands of practicing medicine.

Reduced emotion recognition from nonverbal cues in anorexia nervosa

OBJECTIVE

Recent models of anorexia nervosa (AN) emphasise the role of reduced emotion recognition ability (ERA) in the development and maintenance of the disorder. However, methodological limitations impede conclusions from prior research. The current study tries to overcome these limitations by examining ERA with an audio-visual measure that focuses strictly on multimodal nonverbal cues and allows to differentiate between ERA for different emotion categories.

METHOD

Forty women with AN and 40 healthy women completed the Geneva Emotion Recognition Test. This test includes 83 video clips in which 10 actors express 14 different emotions while saying a pseudo-linguistic sentence without semantic meaning. All clips contain multimodal nonverbal cues (i.e., prosody, facial expression, gestures, and posture).

RESULTS

Patients with AN showed poorer ERA than the healthy control group (d = 0.71), particularly regarding emotions of negative valence (d = 0.26). Furthermore, a lower body weight (r = 0.41) and longer illness duration (ρ = -0.32) were associated with poorer ERA in the AN group.

CONCLUSIONS

Using an ecologically valid instrument, the findings of the study support illness models emphasising poor ERA in AN. Directly addressing ERA in the treatment of AN with targeted interventions may be promising.

Introducing a Face Sort Paradigm to Evaluate Age Differences in Emotion Perception

OBJECTIVES

Previous research has uncovered age-related differences in emotion perception. To date, studies have relied heavily on forced-choice methods that stipulate possible responses. These constrained methods limit discovery of variation in emotion perception, which may be due to subtle differences in underlying concepts for emotion.

METHOD

We employed a face sort paradigm in which young (N = 42) and older adult (N = 43) participants were given 120 photographs portraying six target emotions (anger, disgust, fear, happiness, sadness, and neutral) and were instructed to create and label piles, such that individuals in each pile were feeling the same way.

RESULTS

There were no age differences in number of piles created, nor in how well labels mapped onto the target emotion categories. However, older adults demonstrated lower consistency in sorting, such that fewer photographs in a given pile belonged to the same target emotion category. At the same time, older adults labeled piles using emotion words that were acquired later in development, and thus are considered more semantically complex.

DISCUSSION

These findings partially support the hypothesis that older adults' concepts for emotions and emotional expressions are more complex than those of young adults, demonstrate the utility of incorporating less constrained experimental methods into the investigation of age-related differences in emotion perception, and are consistent with existing evidence of increased cognitive and emotional complexity in adulthood.

Perceiving dynamic emotions expressed simultaneously in the face and body minimizes perceptual differences between young and older adults

OBJECTIVES

It is commonly argued that older adults show difficulties in standardized tasks of emotional expression perception, yet most previous works relied on classic sets of static, decontextualized, and stereotypical facial expressions. In real-life, facial expressions are dynamic and embedded in a rich context, two key factors that may aid emotion perception. Specifically, body language provides important affective cues that may disambiguate facial movements.

METHOD

We compared emotion perception of dynamic faces, bodies, and their combination, in a sample of older (age 60-83, n=126) and young (age 18-30, n=124) adults. We used the Geneva Multimodal Emotion Portrayals (GEMEP) set, which includes a full view of expressers' faces and bodies, displaying a diverse range of positive and negative emotions, portrayed dynamically and holistically in a non-stereotypical, unconstrained manner. Critically, we digitally manipulated the dynamic cue such that perceivers viewed isolated faces (without bodies), isolated bodies (without faces), or faces with bodies.

RESULTS

Older adults showed better perception of positive and negative dynamic facial expressions, while young adults showed better perception of positive isolated dynamic bodily expressions. Importantly, emotion perception of faces with bodies was comparable across ages.

DISCUSSION

Dynamic emotion perception in young and older adults may be more similar than previously assumed, especially when the task is more realistic and ecological. Our results emphasize the importance of contextualized and ecological tasks in emotion perception across ages.

Emotion recognition impairments and social well-being following right-hemisphere stroke

Accurately recognizing and responding to the emotions of others is essential for proper social communication and helps bind strong relationships that are particularly important for stroke survivors. Emotion recognition typically engages cortical areas that are predominantly right-lateralized including superior temporal and inferior frontal gyri - regions frequently impacted by right-hemisphere stroke. Since prior work already links right-hemisphere stroke to deficits in emotion recognition, this research aims to extend these findings to determine whether impaired emotion recognition after right-hemisphere stroke is associated with worse social well-being outcomes. Eighteen right-hemisphere stroke patients (≥6 months post-stroke) and 21 neurologically healthy controls completed a multimodal emotion recognition test (Geneva Emotion Recognition Test - Short) and reported engagement in social/non-social activities and levels of social support. Right-hemisphere stroke was associated with worse emotion recognition accuracy, though not all patients exhibited impairment. In line with hypotheses, emotion recognition impairments were associated with greater loss of social activities after stroke, an effect that could not be attributed to stroke severity or loss of non-social activities. Impairments were also linked to reduced patient-reported social support. Results implicate emotion recognition difficulties as a potential antecedent of social withdrawal after stroke and warrant future research to test emotion recognition training post-stroke.

Is Technology Enhancing or Hindering Interpersonal Communication? A Framework and Preliminary Results to Examine the Relationship Between Technology Use and Nonverbal Decoding Skill

Digital technology has facilitated additional means for human communication, allowing social connections across communities, cultures, and continents. However, little is known about the effect these communication technologies have on the ability to accurately recognize and utilize nonverbal behavior cues. We present two competing theories, which suggest (1) the potential for technology use to enhance nonverbal decoding skill or, (2) the potential for technology use to hinder nonverbal decoding skill. We present preliminary results from two studies to test these hypotheses. Study 1 (N = 410) found that global screen time was unrelated to nonverbal decoding skill. However, how participants spent their time using technology mattered. Participants who reported more active technology use (i.e., posting content) self-reported that their nonverbal decoding skill (as measured by the Emotional Sensitivity subscale of the Social Skills Inventory) was superior but performed worse on objective measures of decoding skill (using standardized tests including the Diagnostic Analysis of Nonverbal Accuracy-Adult Faces and the Workplace Interpersonal Perception Skill). By contrast, passive users performed significantly better on objective measures of nonverbal decoding skill; although they did not self-report any difference in their skill compared to less passive users. Study 2 (N = 190), and a mini-meta analysis of both studies, replicated this pattern. These effects suggest a roadmap for understanding the theoretical relationship between technology use and nonverbal communication skills. We also provide recommendations for future research, including the use of experimental designs to determine causal pathways and to advance our conceptual understanding of the relationship between technology use and nonverbal decoding skill.

Loss of patient centeredness in interpreter-mediated primary care visits

OBJECTIVES

To explore consequences of interpreter mediation of visit communication on patient centered dialogue and patient satisfaction with interpreter listening.

METHODS

Fifty-five professionally interpreted primary care visits were coded using the Roter Interaction Analysis System (RIAS). Two corresponding quantitative measures of patient-centered dialogue were calculated as ratios of psycho-emotional to biomedical statements based on (1) patient and clinician expressed codes and (2) interpreter conveyed codes. Multilevel models examined consequences of interpreter mediation on patient-centered dialogue and patient ratings of interpreter listening.

RESULTS

Study participants included 27 Cantonese, 17 Mandarin and 11 Spanish-speaking primary care patients and 31 of their clinicians. Overall, clinicians expressed 2.26 times more statements and patients expressed 1.74 times more statements than interpreters conveyed. Interpreters conveyed significantly less patient-centered dialogue than expressed by patients and clinicians. All differences were evident within each study language. Interpreter conveyed patient centered dialogue positively predicted patient ratings of interpreter listening (B = 0.817; p < .007).

CONCLUSIONS

The level of interpreter-conveyed patient-centered dialogue was both substantially lower than that expressed by patients and clinicians and a positive predictor of patient satisfaction with interpreter listening.

PRACTICE IMPLICATIONS

Fuller interpretation of patient-centered dialogue may enhance patient experience with interpreters and thereby increase care quality.

Improving emotion recognition in anorexia nervosa: An experimental proof-of-concept study

OBJECTIVE

Previous research has found increasing evidence for difficulties in emotion recognition ability (ERA) and social cognition in anorexia nervosa (AN), and recent models consider these factors to contribute to the development and maintenance of the disorder. However, there is a lack of experimental studies testing this hypothesis. Therefore, the present proof-of-concept study examined whether ERA can be improved by a single session of a computerized training in AN, and whether this has short-term effects on eating disorder symptoms.

METHOD

Forty inpatients (22.20 ± 7.15 years) with AN were randomly assigned to receive a single session of computerized training of ERA (TERA) or a sham training (training the recognition of different types of clouds). ERA, self-reported eating disorder symptoms, and body mass index (BMI) were assessed within 3 days before and after training.

RESULTS

After training, both groups showed improved ERA, reduced self-reported eating disorder symptoms, and an increased BMI. As compared to patients in the control group, patients who received TERA showed greater improvements in ERA and self-reported eating disorder symptoms.

DISCUSSION

ERA can be effectively trained in patients with AN. Moreover, short-term improvements in self-reported eating disorder symptoms provide tentative support for the hypothesis that difficulties in ERA contribute to the maintenance of AN, and that specific trainings of ERA hold promise as an additional component in AN treatment. Future studies are needed to replicate these findings in larger samples, and to investigate long-term effects and transfer into real-world settings.

Tsinghua facial expression database - A database of facial expressions in Chinese young and older women and men: Development and validation

Perception of facial identity and emotional expressions is fundamental to social interactions. Recently, interest in age associated changes in the processing of faces has grown rapidly. Due to the lack of older faces stimuli, most previous age-comparative studies only used young faces stimuli, which might cause own-age advantage. None of the existing Eastern face stimuli databases contain face images of different age groups (e.g. older adult faces). In this study, a database that comprises images of 110 Chinese young and older adults displaying eight facial emotional expressions (Neutral, Happiness, Anger, Disgust, Surprise, Fear, Content, and Sadness) was constructed. To validate this database, each image was rated on the basis of perceived facial expressions, perceived emotional intensity, and perceived age by two different age groups. Results have shown an overall 79.08% correct identification rate in the validation. Access to the freely available database can be requested by emailing the corresponding authors.

Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter

IMPORTANCE

Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction.

OBJECTIVE

To identify evidence and narrative-based practices that promote clinician presence, a state of awareness, focus, and attention with the intent to understand patients.

EVIDENCE REVIEW

Preliminary practices were derived through a systematic literature review (from January 1997 to August 2017, with a subsequent bridge search to September 2019) of effective interpersonal interventions; observations of primary care encounters in 3 diverse clinics (n = 27 encounters); and qualitative interviews with physicians (n = 10), patients (n = 27), and nonmedical professionals whose occupations involve intense interpersonal interactions (eg, firefighter, chaplain, social worker; n = 30). After evidence synthesis, promising practices were reviewed in a 3-round modified Delphi process by a panel of 14 researchers, clinicians, patients, caregivers, and health system leaders. Panelists rated each practice using 9-point Likert scales (-4 to +4) that reflected the potential effect on patient and clinician experience and feasibility of implementation; after the third round, panelists selected their "top 5" practices from among those with median ratings of at least +2 for all 3 criteria. Final recommendations incorporate elements from all highly rated practices and emphasize the practices with the greatest number of panelist votes.

FINDINGS

The systematic literature review (n = 73 studies) and qualitative research activities yielded 31 preliminary practices. Following evidence synthesis, 13 distinct practices were reviewed by the Delphi panel, 8 of which met criteria for inclusion and were combined into a final set of 5 recommendations: (1) prepare with intention (take a moment to prepare and focus before greeting a patient); (2) listen intently and completely (sit down, lean forward, avoid interruptions); (3) agree on what matters most (find out what the patient cares about and incorporate these priorities into the visit agenda); (4) connect with the patient's story (consider life circumstances that influence the patient's health; acknowledge positive efforts; celebrate successes); and (5) explore emotional cues (notice, name, and validate the patient's emotions).

CONCLUSIONS AND RELEVANCE

This mixed-methods study identified 5 practices that have the potential to enhance physician presence and meaningful connection with patients in the clinical encounter. Evaluation and validation of the outcomes associated with implementing the 5 practices is needed, along with system-level interventions to create a supportive environment for implementation.

A comparison of the effectiveness of two types of deceit detection training methods in older adults

Background

In general, people are poor at detecting deception. Older adults are even worse than young adults at detecting deceit, which might make them uniquely vulnerable to certain types of financial fraud. One reason for poor deceit detection abilities is that lay theories of cues to deception are not valid. This study compared the effectiveness of two training methods to improve deceit detection among older adults: valid facial cues versus valid verbal cues to deception. Approximately 150 older adults were randomly assigned to facial training, verbal training, or a control condition. Participants completed a pre-test deceit detection task, their assigned training, and a post-test deceit detection task.

Results

Both training groups significantly improved at recognizing their respectively trained cues after training. However, the facial cue training group were less accurate at detecting deception post-test compared to pre-test and the control group exhibited improved accuracy of deceit detection from pre-test to post-test.

Conclusions

These results are consistent with the body of literature on deception suggesting people hover around chance accuracy, even after training. Older adults’ facial and verbal cue recognition can be improved with training, but these improvements did not translate into more accurate deceit detection, and actually hampered performance in the facial condition. Older adults showed the most benefit from sheer practice at detecting deception (in the control condition), perhaps because this condition encouraged implicit rather than explicit judgments of deception.

A meta-analysis of the relationship between emotion recognition ability and intelligence

The ability to recognise others' emotions from nonverbal cues (emotion recognition ability, ERA) is measured with performance-based tests and has many positive correlates. Although researchers have long proposed that ERA is related to general mental ability or intelligence, a comprehensive analysis of this relationship is lacking. For instance, it remains unknown whether the magnitude of the association varies by intelligence type, ERA test features, as well as demographic variables. The present meta-analysis examined the relationship between ERA and intelligence based on 471 effect sizes from 133 samples and found a significant mean effect size (controlled for nesting within samples) of r = .19. Different intelligence types (crystallized, fluid, spatial, memory, information processing speed and efficiency) yielded similar effect sizes, whereas academic achievement measures (e.g. SAT scores) were unrelated to ERA. Effect sizes were higher for ERA tests that simultaneously present facial, vocal, and bodily cues (as compared to tests using static pictures) and for tests with higher reliability and more emotions. Results were unaffected by most study and sample characteristics, but effect size increased with higher mean age of the sample. These findings establish ERA as sensory-cognitive ability that is distinct from, yet related to, intelligence.

Nonverbal Communication

The field of nonverbal communication (NVC) has a long history involving many cue modalities, including face, voice, body, touch, and interpersonal space; different levels of analysis, including normative, group, and individual differences; and many substantive themes that cross from psychology into other disciplines. In this review, we focus on NVC as it pertains to individuals and social interaction. We concentrate specifically on ( a) the meanings and correlates of cues that are enacted (sent) by encoders and ( b) the perception of nonverbal cues and the accuracy of such perception. Frameworks are presented for conceptualizing and understanding the process of sending and receiving nonverbal cues. Measurement issues are discussed, and theoretical issues and new developments are covered briefly. Although our review is primarily oriented within social and personality psychology, the interdisciplinary nature of NVC is evident in the growing body of research on NVC across many areas of scientific inquiry.

The Impact of Interpersonal Accuracy on Behavioral Outcomes

Interpersonal accuracy, the ability to correctly assess other people’s states or traits, has been studied for over 60 years, and many correlates have been uncovered. Furthermore, theorists routinely propose that having this kind of skill matters for social and workplace outcomes. However, much of the empirical work concerned with interpersonal accuracy does not directly address real-life outcomes for people who have, or lack, this skill. The present article summarizes literature pointing to behavioral correlates of interpersonal accuracy and illustrates when and why interpersonal accuracy is related to favorable interaction outcomes. There seems to be no specific behavior associated with high interpersonal accuracy. Instead, interpersonal accuracy seems to foster behavioral adaptability, the ability to change one’s behavior to match the expectations of the social interaction partner. This behavioral adaptability might be responsible for the positive interaction outcomes related to interpersonal accuracy. We illustrate the mechanism and boundary conditions underlying and framing how interpersonal accuracy affects interaction outcomes and discuss future directions in research on interpersonal accuracy.