Addressing deficits in emotion recognition after severe traumatic brain injury: The role of focused attention and mimicry

Deficits in emotion perception are prevalent in people with severe traumatic brain injury (TBI) and are an important target for remediation. Preliminary work has indicated that emotion perception can improve with treatment but there is a dearth of studies examining the efficacy of specific techniques. In this study we examined two remediation strategies: (1) focusing attention on relevant aspects of the facial expression, and (2) mimicking the facial expression. Twenty-two people with chronic, severe brain injuries and 32 people matched on basic demographic variables were asked to label six basic emotions spontaneously followed by either a Focus or Mimic instructional strategy. Contrary to expectations, the TBI group was not poorer than the control group in the Spontaneous condition. Consequently, the effects of Focus vs. Mimic were examined for participants who had average scores or less in the Spontaneous condition (n = 14 and 20, respectively). The poorer performing control group was found to benefit from repeated exposure regardless of remediation strategy. The TBI group did not. Over and above repeated exposure, the Focus instruction assisted control participants but lead to poorer performance in those with TBI. The Mimic strategy resulted in little improvement for either group. Those who benefited least from the Focus strategies in the TBI group were those with poor abstract reasoning and flexibility. There was no such association in the control group and no associations between cognitive abilities and changes in scores using the Mimic strategy in either group.