Affect Recognition and Empathy. Barry Willer, PhD

Transcription

1 Affect Recognition and Empathy Barry Willer, PhD

2 Colleagues: Dawn Neumann PhD, Duncan Babbage PhD, Barbra Zupan PhD,

3 Acknowledgement National Institute on Disability and Rehabilitation Research (H133G080043)

4 Case Example Bob and Mary Bob was a fireman. Mary was just starting her own consulting business. The 2 boys were good students and well adjusted. Bob received a severe brain injury in 2006.

5 Case Example After Bob s accident Mary coped amazingly and the boys seemed to mature fast By 2011 Bob was seen as a remarkable recovery. Some of his friends said he seemed his old self again Mary saw things otherwise: Bob s personality has changed. He is not the man I married.

6 Case Example How Was Bob Different? When Bob s dog Boo died Bob seemed strangely unaffected. He told inappropriate jokes about Boo while the boys had tears in their eyes.

7 Case Example How had Bob changed? Bob had become house husband Sometimes he looked after things and sometimes he seemed to forget One day he forgot to pick up one son from Band Practice (Mary got the call) When Mary confronted Bob, he laughed. This made Mary furious and later she cried, alone.

8 Case Example So How was Mary doing Really? To Everyone Else Mary is a Saint Mary felt she lost her best friend and confidant in the accident. Laughing incident highlighted Bob s inability to see Mary as having feelings and her own issues. He never asks me how I am feeling! Bob is incapable of making decisions. This makes Bob dependent on Mary for everything. Not a good situation for either Mary or Bob.

9 What is wrong with Bob? Cognitive: Memory deficits? Initiation? Relies heavily on his diary for to do s Behavior: Pseudo Psychopathy? Bob rarely gets angry although he is sometimes frustrated when he does not meet Mary s expectations. Might be depressed. Physical/Motor: Almost full recovery with slight limp on right leg Bob is impaired in emotion recognition

10 Emotions Happy Sad Angry Frightened Disgusted Surprised Neutral

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12 Happy Sad

13 Happy Sad Presented Visually

14 Happy Sad Presented Visually

15 Happy Sad Presented Visually

16 Happy Sad Presented Visually

17 Happy Sad Presented Visually Ventral Striatum

18 Happy Sad Presented Visually Ventral Striatum

19 Happy Sad Presented Visually Ventral Striatum Cingulate

20 Happy Sad Presented Visually Ventral Striatum Cingulate

21 Happy Sad Presented Visually Ventral Striatum Cingulate

22 Happy Sad Presented Visually Visceral Response Ventral Striatum Cingulate

23 Happy Sad Presented Visually Visceral Response Ventral Striatum Cingulate

24 Happy Sad Presented Visually Visceral Response Ventral Striatum Cingulate

25 Happy Sad Presented Visually Visceral Response Ventral Striatum Cingulate

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27 Threat

28 Threat visual

29 Threat visual

30 Threat visual

31 Threat visual Amygdala

32 Threat visual Amygdala

33 Ventral Striatum Threat visual Amygdala

34 Ventral Striatum Threat visual Amygdala

35 Ventral Striatum Threat visual Amygdala

36 Ventral Striatum Threat visual Amygdala

37 Ventral Striatum Threat visual Amygdala Visceral Response

38 Ventral Striatum Threat visual Amygdala Visceral Response

39 Ventral Striatum Threat visual Amygdala Visceral Response

40 Ventral Striatum Threat visual Amygdala Visceral Response

41 Happy

42 Disgust Activation of the anterior insula Response to things we find disgusting (smells, visual stimuli, rotting animal parts) Appears to be an emotion that protects us from eating rotten food

43 Disgust Activation of the anterior insula Response to things we find disgusting (smells, visual stimuli, rotting animal parts) Appears to be an emotion that protects us from eating rotten food Emotion and emotional expressions are universal

44 Recognizing Affect in Others Visual: Facial expressions Body language Auditory (Intonation) Contextual osocial inferencing otheory of Mind

45 Our Brain Is Wired For Human Interaction (and facial recognition))

46 Tests of Affect Recognition

47 Tests of Affect Recognition

48 Tests of Affect Recognition

49 Tests of Affect Recognition We test for facial affect recognition, auditory affect recognition, (DANVA; FAB) Dynamic Affect recognition (videos) TASIT

50 Developed Two Approaches to Treatment Facial Affect Recognition (FAR) Specifically taught Ss to Analyse Emotional Expressions in Faces Stories of Emotional Inferencing (SEI) Used short stories to teach Ss to infer emotions Computer Assisted to ensure consistency across therapists

51 Facial Affect Recognition FAR Content Stimuli 40 faces. Happy, sad, angry, fearful. Ethnicity, gender, intensity. Program Seven levels. Repeating structure. Increasing difficulty. Vanishing cues. Reducing intensity.

52 Facial Affect Recognition Feature processing

53 Facial Affect Recognition Emotion sensation

54 Facial Affect Recognition Conceptualization Describe a situation Describe bodily sensations Generate bodily sensations. Generate facial expressions. Identify matching facial expression Discuss thoughts and feelings Self and others.

55 Interventions Stories of Emotional Inference Context processing Identify emotions of characters in stories. Emotion sensation Describe, generate sensations. (No mirror.) Conceptualization In-depth discussion of a past emotional event.

56 Interventions Control Group Experience Cognitive skills Speed of processing. Attention. Memory. Planning. Problem solving. ADLs. Clinically plausible Participants highly motivated.

57 Research Study Inclusion Traumatic brain injury Moderate to severe. Injury after 8 years. Impaired facial affect recognition Other characteristics Follow oral and written directions. Adequate comprehension years old. Informant.

58 Research Study Exclusion Substance dependence Preexisting: Major psychiatric disorder. Neurological disorder.

59 Research Study Participants Screened: 203 Ontario: 41 US: 108 NZ: 54 Severity Moderate: 4 Unclear: 6 Severe: 193 Gender Males: 150 Females: 53 Age Mean: 39.6 yrs Range: 20 69* yrs Education Mean: yrs Range: 7 20 yrs Time Since Injury Mean: yrs Range: 1 42 yrs Cause MVA: 62% Fall: 14% Assault: 7% Other: 17%

60 Primary Outcome Measures Facial affect recognition Diagnostic Analysis of Nonverbal Affect (DANVA)-2 Adult Faces Happy, Sad, Angry, Fearful. Nowicki (2008)

61 Primary Outcome Measures Emotional inferencing Emotional Inference Stories Test (EIST) 12 stories. Story on single screen. Question on single screen. Accompanying audio in neutral tone. Grade 6 reading level. Word count range: (Unpublished)

62 Additional Measures Relationships and empathy Interpersonal Reactivity Index (IRI) Empathic Concern, Perspective Taking subscales. Participant and informant. (Analysis ongoing.) Cognitive empathy Emotional Empathy

63 Additional Measures Community Integration Questionnaire Neuropsychiatric Inventory DANVA Adult Paralanguage Florida Affect Battery 3 Brief Smell Identification Test

64 Retention Screen n=203 Excluded n=115 Pre-Test n=88 Excluded n=18 Randomized n=70 FAR n=23 SEI n=23 Control n=24 Post-Test n=22 Post-Test n=22 Post-Test n=21 3 months n=20 3 months n=20 3 months n=20 6 months n=19 6 months n=17 6 months n=19

65 Results DANVA Faces: FAR vs Control FAR better at recognizing facial affect than Controls at post-tests

66 Results DANVA Faces: SEI vs. Control SEI not better than Controls recognizing facial affect at post-tests

67 Results Emotional Inferences from Stories: FAR vs Control FAR not better at inferring emotions from context compared to Controls at post-tests

68 Results Emotional Inferences from Stories: SEI vs Control SEI not better at inferring emotions from context compared to Controls at post-tests

69 Conclusions Emotion recognition after severe TBI exists for about 30% (men and women) Facial Affect Recognition (FAR) Training was effective in the RCT Stories of Emotional Inference (SEI) training did not appear to be effective

70 Further Observations Best part of the FAR training may have been the supplemental components 1.Mirror training 2.Remembering emotions 3.Practicing emotions

71 Case Example Back to Bob and Mary Bob did not see value in the therapy Eventually Bob did realize he was missing something, others emotions Practiced facial expressions until his face hurt One of the most remarkable recoveries His wife could not believe the change She described how one day he asked her how her day had gone and she broke into tears

72 Final thoughts Affect recognition is important as a building block for Empathy and ultimately for maintaining relationships Individuals with the lowest scores on empathy were less likely to have continued support from family

73 Final thoughts Affect recognition does not appear to recover spontaneously However, even after many years individuals can re-learn affect recognition Powerful influence on family relations Powerful influence on quality of life Not sure it made a difference on Empathy

74 Summary Discussion Network of users Updates list Questions?

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