Sensitivity to basic emotional expressions and the emotion perception space in the absence of facial mimicry: The case of individuals with congenital facial palsy

According to sensorimotor simulation models, recognition of another person's emotion is achieved by recreating the motor production of the perceived facial expression in oneself. Therefore, congenital difficulties in the production of facial expressions may affect emotion processing. The present study assessed a sample (N = 11) of Moebius syndrome (MBS) patients and a matched control group (N = 33), using a highly sensitive emotion recognition task. Leveraging the uniqueness of MBS, which is characterized by congenital facial paralysis, the role of facial mimicry and sensorimotor simulation in creating precise embodied concepts of emotion categories was investigated. Particularly, the research focused on how MBS patients (both as a group and individually, compared to controls) perceived the intensity of primary emotions and how well they discriminated between these and secondary (i.e., blended) emotions. The results showed that MBS patients registered significantly lower intensities for sadness, fear, anger, and disgust. Furthermore, these emotions appeared closely clustered-and therefore confused with anger and surprise-in the multidimensional scaling map, which was used to qualitatively analyze the emotion perception space. Further analysis of each MBS participant showed a stronger tendency in most patients to perceive primary emotions as less intense, relative to controls. Thus, the findings provide evidence for a residual deficit in emotion processing in adults with MBS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental Health Literacy about Personality Disorders: A Multicultural Study

Mental health literacy (MHL) refers to lay people's knowledge and beliefs about the diagnosis and treatment of mental illness. The current study aimed at investigating MHL regarding personality disorders (PDs) multiculturally, comparing Turkish and Italian populations. In total, 262 participants responded to an online vignette identification task that required them to label the PDs of seven hypothetical subjects and rate various dimensions of their disorders. Narcissistic (25%), obsessive-compulsive (13%), and paranoid (12%) PDs were the most correctly labeled, while the average accuracy values for other PDs were below 0.04%. Compared to Turkish participants, Italian participants were more accurate in labeling narcissistic PD. Additionally, of the seven PDs, narcissistic PD was associated with the most happiness and success at work. Subjects with borderline and avoidant PDs were the most recognized as having psychological problems (>90%), yet their PDs were among the least correctly identified. Overall, participants from both cultures were generally successful at recognizing the presence of a mental illness, but they rarely labeled it correctly. Only limited cultural differences emerged. The present findings may inform the design of outreach programs to promote MHL regarding PDs, thereby facilitating early recognition of PDs and help-seeking behaviors for affected individuals.

Close to me but unreachable: Spotting the link between peripersonal space and empathy

The space surrounding the body (i.e., peripersonal space, PPS) has a crucial impact on individuals' interaction with the environment. Research showed that interaction within the PPS increases individuals' behavioral and neural responses. Furthermore, individuals' empathy is affected by the distance between them and the observed stimuli. This study investigated empathic responses to painfully stimulated or gently touched faces presented within the PPS depending on the presence vs. absence of a transparent barrier erected to prevent interaction. To this aim, participants had to determine whether faces were painfully stimulated or gently touched while their electroencephalographic (EEG) signals were recorded Brain activity (i.e., event-related potentials [ERPs], source activations) was separately compared for the two types of stimuli (i.e., gently touched vs. painfully stimulated faces) across two barrier conditions: (a) no barrier between participants and the screen (i.e., no-barrier) and (b) a plexiglass barrier erected between participants and the screen (i.e., barrier). While the barrier did not affect performance behaviorally, it reduced cortical activation at both the ERP and source activation levels in brain areas that regulate interpersonal interaction (i.e., primary, somatosensory, premotor cortices; inferior frontal gyrus). These findings suggest that the barrier, precluding the possibility of interacting, reduced the observer's empathy.

Degenerate pathway for processing smile and other emotional expressions in congenital facial palsy: an hdEEG investigation

Influential theoretical models argue that an internal simulation mechanism (motor or sensorimotor simulation) supports the recognition of facial expressions. However, despite numerous converging sources of evidence, recent studies testing patients with congenital facial palsy (i.e. Moebius syndrome) seem to refute these theoretical models. However, these results do not consider the principles of neuroplasticity and degeneracy that could support the involvement of an alternative neural processing pathway in these patients. In the present study, we tested healthy participants and participants with Moebius syndrome in a highly sensitive facial expression discrimination task and concomitant high-density electroencephalographic recording. The results, both at the scalp and source levels, indicate the activation of two different pathways of facial expression processing in healthy participants and participants with Moebius syndrome, compatible, respectively, with a dorsal pathway that includes premotor areas and a ventral pathway. Therefore, these results support the reactivation of sensorimotor representations of facial expressions (i.e. simulation) in healthy subjects, in the place of an alternative processing pathway in subjects with congenital facial palsy.

This article is part of the theme issue ‘Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience’.

A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis

Objective

Youths at clinical high risk for psychosis (CHR-P) are characterized by a high prevalence of anxiety and depressive disorders. The present study aimed at developing and analyzing a network structure of CHR-P symptom domains (i.e., positive, negative, disorganization, and general subclinical psychotic symptoms), depressive and anxiety symptoms, and general functioning.

Methods

Network analysis was applied to data on 111 CHR-P children and adolescents (M age = 14.1), who were assessed using the Structured Interview for Prodromal Syndromes, the Children's Depression Inventory, the Children's Global Assessment Scale, and the Multidimensional Anxiety Scale for Children.

Results

In the network, negative and disorganization symptoms showed the strongest association (r = 0.71), and depressive and anxiety symptoms showed dense within-domain connections, with a main bridging role played by physical symptoms of anxiety. The positive symptom cluster was not associated with any other node. The network stability coefficient (CS) was slightly below 0.25, and observed correlations observed ranged from 0.35 to 0.71.

Conclusion

The lack of association between subclinical positive symptoms and other network variables confirmed the independent nature of subclinical positive symptoms from comorbid symptoms, which were found to play a central role in the analyzed network. Complex interventions should be developed to target positive and comorbid symptoms, prioritizing those with the most significant impact on functioning and the most relevance for the young individual, through a shared decision-making process. Importantly, the results suggest that negative and disorganization symptoms, as well as depressive and anxiety symptoms, may be targeted simultaneously.

Post-surgery Rehabilitative Intervention Based on Imitation Therapy and Mouth-Hand Motor Synergies Provides Better Outcomes in Smile Production in Children and Adults With Long Term Facial Paralysis

Rehabilitation after free gracilis muscle transfer (smile surgery, SS) is crucial for a functional recovery of the smiling skill, mitigating social and psychological problems resulting from facial paralysis. We compared two post-SS rehabilitation treatments: the traditional based on teeth clenching exercises and the FIT-SAT (facial imitation and synergistic activity treatment). FIT-SAT, based on observation/imitation therapy and on hand-mouth motor synergies would facilitate neuronal activity in the facial motor cortex avoiding unwanted contractions of the jaw, implementing muscle control. We measured the smile symmetry on 30 patients, half of whom after SS underwent traditional treatment (control group, CG meanage = 20 ± 9) while the other half FIT-SAT (experimental group, EG meanage= 21 ± 14). We compared pictures of participants while holding two postures: maximum and gentle smile. The former corresponds to the maximal muscle contraction, whereas the latter is strongly linked to the control of muscle strength during voluntary movements. No differences were observed between the two groups in the maximum smile, whereas in the gentle smile the EG obtained a better symmetry than the CG. These results support the efficacy of FIT-SAT in modulating the smile allowing patients to adapt their smile to the various social contexts, aspect which is crucial during reciprocal interactions.

A bilateral SPCN is elicited by to-be-memorized visual stimuli displayed along the vertical midline

We recently showed that deploying attention to target stimuli displayed along the vertical meridian elicits a bilateral N2pc, that we labeled N2pcb (Psychophysiology). Here we investigated whether a different component, the sustained posterior contralateral negativity (SPCN), shows the same property when a varying number of visual stimuli are displayed either laterally or on the vertical meridian. We displayed one or two cues that designated candidate targets to be detected in a search array that was displayed after a retention interval. The cues were either on the horizontal meridian or on the vertical meridian. When the cues were on the horizontal meridian, we observed an N2pc followed by an SPCN in their classic form, as negativity increments contralateral to the cues. As expected, SPCN amplitude was greater when two cues had to be memorized than when only one cue had to be memorized. When the cues were on the vertical meridian, we observed an N2pcb followed by a bilateral SPCN (or SPCNb). Critically, like SPCN, SPCNb amplitude was greater when two cues had to be memorized than when only one cue had to be memorized. A series of additional parametrical and topographical comparisons between N2pcb and SPCNb revealed similarities but also some important differences between these two components that we interpreted as evidence for their distinct neural sources.

We challenge the view that the SPCN ERP component cannot track the memory maintenance of objects displayed along the vertical meridian. Owing to the receptive fields of posterior neurons straddling on the intersection of the two visual hemifields, bilateral N2pc (N2pcb) and SPCN (SPCNb) activity can be detected using a cued visual search design.

Shared Attention Amplifies the Neural Processing of Emotional Faces

Sharing an experience, without communicating, affects people's subjective perception of the experience, often by intensifying it. We investigated the neural mechanisms underlying shared attention by implementing an EEG study where participants attended to and rated the intensity of emotional faces, simultaneously or independently. Participants performed the task in three experimental conditions: (a) alone; (b) simultaneously next to each other in pairs, without receiving feedback of the other's responses (shared without feedback); and (c) simultaneously while receiving the feedback (shared with feedback). We focused on two face-sensitive ERP components: The amplitude of the N170 was greater in the "shared with feedback" condition compared to the alone condition, reflecting a top-down effect of shared attention on the structural encoding of faces, whereas the EPN was greater in both shared context conditions compared to the alone condition, reflecting an enhanced attention allocation in the processing of emotional content of faces, modulated by the social context. Taken together, these results suggest that shared attention amplifies the neural processing of faces, regardless of the valence of facial expressions.

Intra-individual behavioural and neural signatures of audience effects and interactions in a mirror-game paradigm

We often perform actions while observed by others, yet the behavioural and neural signatures of audience effects remain understudied. Performing actions while being observed has been shown to result in more emphasized movements in musicians and dancers, as well as during communicative actions. Here, we investigate the behavioural and neural mechanisms of observed actions in relation to individual actions in isolation and interactive joint actions. Movement kinematics and EEG were recorded in 42 participants (21 pairs) during a mirror-game paradigm, while participants produced improvised movements alone, while observed by a partner, or by synchronizing movements with the partner. Participants produced largest movements when being observed, and observed actors and dyads in interaction produced slower and less variable movements in contrast with acting alone. On a neural level, we observed increased mu suppression during interaction, as well as to a lesser extent during observed actions, relative to individual actions. Moreover, we observed increased widespread functional brain connectivity during observed actions relative to both individual and interactive actions, suggesting increased intra-individual monitoring and action-perception integration as a result of audience effects. These results suggest that observed actors take observers into account in their action plans by increasing self-monitoring; on a behavioural level, observed actions are similar to emergent interactive actions, characterized by slower and more predictable movements.

How Does It Feel to Be Online? Psychotherapists' Self-Perceptions in Telepsychotherapy Sessions During the COVID-19 Pandemic in Italy

Aims: The COVID-19 pandemic and consequent extreme restrictions imposed by governments across the world forced psychotherapists to abruptly change their working modality. The first aim of the current study was to assess psychotherapists’ self-perceptions (i.e., affective and cognitive perceptions about their self and their self in relation to clients) when providing telepsychotherapy during the first peak of the COVID-19 pandemic in Italy. The second aim was to explore the associations between psychotherapists’ self-perceptions, characteristics, and clinical practices.

Method: An online survey was administered to 281 Italian licensed psychotherapists (M_age=45.15; SD=10.2; 83.6% female) between April 5 and May 10, 2020. The survey comprised ad-hoc questions that were designed to collect sociodemographic details and information related to working practices. Moreover, a semantic differential (SD) scale was developed to assess psychotherapists’ self-perceptions, and a factor analysis was performed from the SD items.

Results: The SD scale showed an overall trend of positive psychotherapist self-perception during telepsychotherapy, despite reports of greater fatigue and directive and talkative behavior during sessions. Four SD factors accounted for 45% of the variance: “Affective Availability,” “Attitude Predisposition,” “Well-being,” and “Interventionism.” Scores on the first three factors were indicative of psychotherapists’ Positive vs. Negative self-perception. A comparison of the Positive and Negative attitudinal profiles using the chi-squared test with Yates’s correction and a Monte Carlo simulation found that psychotherapists with a Positive profile reported greater satisfaction with the telematic modality and were more likely to perceive that their clients were able to maintain privacy during sessions.

Conclusion: The results suggest that Italian psychotherapists have been able to promptly adapt to the imposed telematic modality during the COVID-19 pandemic. However, they may have attempted to compensate for their physical distance from clients by intervening more during sessions. These findings may support psychotherapists who are currently practicing and inform future practitioners who are considering the use of telematic treatment as a routine component of psychotherapeutic care.

Altering sensorimotor simulation impacts early stages of facial expression processing depending on individual differences in alexithymic traits

Simulation models of facial expressions suggest that posterior visual areas and brain areas underpinning sensorimotor simulations might interact to improve facial expression processing. According to these models, facial mimicry, a manifestation of sensorimotor simulation, may contribute to the visual processing of facial expressions by influencing early stages. The aim of this study was to assess whether and how sensorimotor simulation influences early stages of face processing, also investigating its relationship with alexithymic traits given that previous studies have suggested that individuals with high levels of alexithymic traits (vs. individuals with low levels of alexithymic traits) tend to use sensorimotor simulation to a lesser extent. We monitored P1 and N170 ERP components of the event-related potentials (ERP) in participants performing a fine discrimination task of facial expressions and animals, as a control condition. In half of the experiment, participants could freely use their facial mimicry whereas in the other half they had their facial mimicry blocked by a gel. Our results revealed that only individuals with lower compared to high alexithymic traits showed a larger modulation of the P1 amplitude as a function of the mimicry manipulation selectively for facial expressions (but not for animals), while we did not observe any modulation of the N170. Given the null results at the behavioural level, we interpreted the P1 modulation as compensative visual processing in individuals with low levels of alexithymia under conditions of interference on the sensorimotor processing, providing a preliminary evidence in favor of sensorimotor simulation models.

Psychotherapy During COVID-19: How the Clinical Practice of Italian Psychotherapists Changed During the Pandemic

Aims: Italy was one of the first countries to be significantly affected by the coronavirus disease 2019 (COVID-19) pandemic, determining a unique scenario for Italian psychotherapists to consider changing the modality in which they deliver treatment. The present study aimed at studying which factors related to psychotherapists and their clinical practice had a major role in predicting two main outcomes: (1) the rate of interrupted treatments during lockdown and (2) psychotherapists' satisfaction with the telepsychotherapy modality. Methods: An online survey was administered to licensed psychotherapists (n = 306), who worked mainly as private practitioners, between April 5 and May 10, 2020 (i.e., the peak of the pandemic in Italy). Results: Psychotherapists reported that 42.1% (SD = 28.9) of their treatments had been interrupted, suggesting that Italy faced an important undersupply of psychotherapy during the lockdown. Using the Akaike information criterion (AIC) model selection, we identified three predictors of the rate of interrupted treatments: (1) psychotherapists' lack of experience with telepsychotherapy prior to the lockdown, (2) their theoretical orientation (with cognitive behavioral psychotherapists reporting a higher rate of interrupted treatments), and (3) patients' lack of privacy at home, as reported to the psychotherapists. Furthermore, we found four predictors of psychotherapists' satisfaction with the telepsychotherapy modality: (1) the rate of interrupted treatments, (2) psychotherapists' previous experience with telepsychotherapy, (3) their beliefs about the compatibility of telepsychotherapy with their theoretical orientation, and (4) their use of a video-conferencing modality, rather than telephone. Conclusion: The following recommendations can help policy makers, professional associations, and practitioners in promoting the continuity of psychotherapy treatments during the COVID-19 outbreak and in future emergencies: (i) disseminating training programs for practitioners on telepsychotherapy, (ii) supporting patients to pragmatically access a private space at home, (iii) encouraging practitioners to use video-conferencing (instead of telephone) to deliver remote therapy, and (iv) increasing the acceptance of telepsychotherapy among both clinicians and the general public.

Neural measures of the causal role of observers' facial mimicry on visual working memory for facial expressions

Simulation models of facial expressions propose that sensorimotor regions may increase the clarity of facial expressions representations in extrastriate areas. We monitored the event-related potential marker of visual working memory (VWM) representations, namely the sustained posterior contralateral negativity (SPCN), also termed contralateral delay activity, while participants performed a change detection task including to-be-memorized faces with different intensities of anger. In one condition participants could freely use their facial mimicry during the encoding/VWM maintenance of the faces while in a different condition participants had their facial mimicry blocked by a gel. Notably, SPCN amplitude was reduced for faces in the blocked mimicry condition when compared to the free mimicry condition. This modulation interacted with the empathy levels of participants such that only participants with medium-high empathy scores showed such reduction of the SPCN amplitude when their mimicry was blocked. The SPCN amplitude was larger for full expressions when compared to neutral and subtle expressions, while subtle expressions elicited lower SPCN amplitudes than neutral faces. These findings provide evidence of a functional link between mimicry and VWM for faces and further shed light on how this memory system may receive feedbacks from sensorimotor regions during the processing of facial expressions.

Out of Sight Out of Mind: Perceived Physical Distance Between the Observer and Someone in Pain Shapes Observer's Neural Empathic Reactions

Social and affective relations may shape empathy to others' affective states. Previous studies also revealed that people tend to form very different mental representations of stimuli on the basis of their physical distance. In this regard, embodied cognition and embodied simulation propose that different physical distances between individuals activate different interpersonal processing modes, such that close physical distance tends to activate the interpersonal processing mode typical of socially and affectively close relationships. In Experiment 1, two groups of participants were administered a pain decision task involving upright and inverted face stimuli painfully or neutrally stimulated, and we monitored their neural empathic reactions by means of event-related potentials (ERPs) technique. Crucially, participants were presented with face stimuli of one of two possible sizes in order to manipulate retinal size and perceived physical distance, roughly corresponding to the close and far portions of social distance. ERPs modulations compatible with an empathic reaction were observed only for the group exposed to face stimuli appearing to be at a close social distance from the participants. This reaction was absent in the group exposed to smaller stimuli corresponding to face stimuli observed from a far social distance. In Experiment 2, one different group of participants was engaged in a match-to-sample task involving the two-size upright face stimuli of Experiment 1 to test whether the modulation of neural empathic reaction observed in Experiment 1 could be ascribable to differences in the ability to identify faces of the two different sizes. Results suggested that face stimuli of the two sizes could be equally identifiable. In line with the Construal Level and Embodied Simulation theoretical frameworks, we conclude that perceived physical distance may shape empathy as well as social and affective distance.

Neural measures of the role of affective prosody in empathy for pain

Emotional communication often needs the integration of affective prosodic and semantic components from speech and the speaker’s facial expression. Affective prosody may have a special role by virtue of its dual-nature; pre-verbal on one side and accompanying semantic content on the other. This consideration led us to hypothesize that it could act transversely, encompassing a wide temporal window involving the processing of facial expressions and semantic content expressed by the speaker. This would allow powerful communication in contexts of potential urgency such as witnessing the speaker’s physical pain. Seventeen participants were shown with faces preceded by verbal reports of pain. Facial expressions, intelligibility of the semantic content of the report (i.e., participants’ mother tongue vs. fictional language) and the affective prosody of the report (neutral vs. painful) were manipulated. We monitored event-related potentials (ERPs) time-locked to the onset of the faces as a function of semantic content intelligibility and affective prosody of the verbal reports. We found that affective prosody may interact with facial expressions and semantic content in two successive temporal windows, supporting its role as a transverse communication cue.