How Traumatic Brain Injuries can Contribute to Social Isolation
People who are recovering from traumatic brain injuries (TBI) frequently report feeling socially isolated following their injury. When areas of the brain responsible for perceiving and conveying information are damaged, it becomes a challenge for patients to relate to others, maintain relationships, and adhere to rehabilitative treatments. These challenges can negatively impact community integration, the many ways a patient is connected to their community, leading to feelings of social isolation. A common impairment caused by TBI that impacts community integration is diminished facial affect recognition (FAR), which is the ability to recognize and perceive facial affects and emotions expressed through facial expressions. An estimated 39% of individuals with moderate to severe TBI experience FAR deficits. To address this challenge, researchers at Rutgers University studied the relationship in TBI individuals between impairments in facial affect recognition and community integration.
In this study, 27 individuals with moderate to severe TBI and 30 healthy controls participated in two types of tests to measure facial affect recognition, followed by a community integration survey and cognitive exam. The two types of FAR tests administered were a static test and a dynamic test. The static FAR test included 36 images of actors with 6 choices of emotions to choose from for each image, while the dynamic FAR test included videos of actors expressing different emotions in everyday environments to more closely resemble real life, with 7 choices of emotions to choose from for each video. The community integration survey assessed community integration in three subcategories: home integration, social integration, and productivity. The cognitive exam was used to analyze other deficits associated with TBI, and help determine if differences between the control and the TBI group in community integration was due to FAR or other cognitive impairments.
In the static FAR test, better performance was significantly correlated with a higher score on the community integration survey, especially on the productivity subscale. Similarly in the dynamic FAR test, greater recognition of anger was correlated with higher social integration and correct identification of revulsion was positively associated with productivity. In general, higher scores were associated with higher levels of community integration. The researchers concluded that the relationship between FAR and productivity suggests that the impact of FAR deficits are more pronounced when interacting with those who are not close friends or family members, such as co-workers.
In this study, 27 individuals with moderate to severe TBI and 30 healthy controls participated in two types of tests to measure facial affect recognition, followed by a community integration survey and cognitive exam. The two types of FAR tests administered were a static test and a dynamic test. The static FAR test included 36 images of actors with 6 choices of emotions to choose from for each image, while the dynamic FAR test included videos of actors expressing different emotions in everyday environments to more closely resemble real life, with 7 choices of emotions to choose from for each video. The community integration survey assessed community integration in three subcategories: home integration, social integration, and productivity. The cognitive exam was used to analyze other deficits associated with TBI, and help determine if differences between the control and the TBI group in community integration was due to FAR or other cognitive impairments.
In the static FAR test, better performance was significantly correlated with a higher score on the community integration survey, especially on the productivity subscale. Similarly in the dynamic FAR test, greater recognition of anger was correlated with higher social integration and correct identification of revulsion was positively associated with productivity. In general, higher scores were associated with higher levels of community integration. The researchers concluded that the relationship between FAR and productivity suggests that the impact of FAR deficits are more pronounced when interacting with those who are not close friends or family members, such as co-workers.
Image Source: Leah Kelley
Due to the small sample size in this study, more research is needed to further investigate the relationship between facial affect recognition and community integration before definitive conclusions can be made. However, based on current findings, there is a clear need for both robust mental health services and TBI patient support that can help address the common experience of social isolation. The relationship between FAR deficits and decreased productivity also demonstrates the necessity for increased awareness of the challenges TBI patients face in the workplace. According to the Brain Injury Association of America, the goals of patient-centered, community based therapy range greatly based on the patient’s needs, from returning to work to caring for children, so navigating FAR impairments should likewise address the treatment goals of each patient. Since no two brain injuries or patients are exactly alike, the treatments for TBI’s need to be personalized and this should be reflected in how FAR deficits are studied and understood.
Featured Image Source: Nathan Cowley
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