Recognition of facial and vocal affect following traumatic brain injury

Objective: Studies of facial affect recognition by people with traumatic brain injury (TBI) have shown this to be a significant problem. Vocal affect recognition also appears to be challenging for this population, but little is known about the degree to which one modality is impaired compared to the other. This study compared facial and vocal affect recognition of high and low intensity emotion expressions in people with moderate-to-severe TBI. Methods: The Diagnostic Analysis of Nonverbal Accuracy-2 (Adult Faces; Voices) was administered to 203 participants with TBI. Results: Adults with TBI identified vocal emotion expressions with greater accuracy than facial emotion expressions. Facial affect recognition impairment was identified in 34% of participants, 22% were classified as having vocal affect recognition impairment and 15% showed impairment in both modalities. Participants were significantly less accurate at identifying low vs high intensity emotion expressions in both modalities. Happy facial expressions were significantly better identified than all other emotions. Errors were distributed across the emotion categories for vocal expressions. Conclusions: The degree of facial affect impairment was significantly greater than vocal affect impairment in this sample of people with moderate-to-severe TBI. Low intensity emotion expressions were particularly problematic and an advantage for positively valenced facial emotion expressions was indicated.