Individuals who are unable to interpret emotions following a severe brain injury have been offered a new hope, after a group of researchers suggested that the patients can regain the vital social skill by being re-educated to read body language, facial expressions and voice tone in others.
The research, published in the Journal of Head Trauma Rehabilitation, reveals that appropriate training can result in significant gains in "emotional perception", which is crucial for successful social communication.
The study involved 18 participants recruited from an outpatient service at the Liverpool Hospital Brain Injury Rehabilitation Unit, in Sydney, Australia.
All had experienced a severe traumatic brain injury at least six months earlier and had significantly impaired ability to interpret emotions in others.
Observations by clinicians or the participants themselves had identified chronic social difficulties or isolation, an apparent disregard or a lack of awareness of social cues, or inappropriate social responding.
Someone who has suffered traumatic brain injury - commonly due to a blow to the skull - can lose the ability to accurately read other people's emotional cues, which may make their social behaviour awkward, badly timed or miscalculated, notes the study's lead author, UNSW clinical psychologist, Dr Cristina Bornhofen.
"These people find it difficult to integrate the cluster of non-verbal cues that accompany speech," says Bornhofen.
"Their inability to interpret emotional expression causes significant frustration because it impairs their social competence," the expert added.
They may have difficulty interpreting an emotion such as sarcasm, for example, in which a positive verbal message is paired with a voice tone and facial expression intended to convey a meaning opposite to the verbal message.
Traditional treatments have emphasised training in positive social behaviours, such as turn-taking, giving compliments, and reducing undesirable behaviours, such as excessive talking and inappropriate conversation topics, Dr Bornhofen says. However, these programs have had limited success.
"Good social communication is possible only if people can effectively use feedback, such as that provided by the emotional responses of others. Behaviourally-oriented programs have tended to neglect this critical aspect of social skills," she says.