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Access Type
WSU Access
Date of Award
January 2024
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Psychology
First Advisor
Lisa J. Rapport
Abstract
Introduction: Although the high prevalence of poor social well-being after traumatic brain injury (TBI) is well documented, the underlying mechanisms remain unclear. Impairments in experienced and receptive emotion processing, such as empathy and facial affect recognition, are common after TBI. These abilities are thought to be critical to successful social outcomes. However, most research focuses on experimental tasks and questionnaires that are purported to assess these abilities, but these tasks and questionnaires are not directly connected to real-world social integration outcomes, such as community integration, companionship, emotional support, social isolation, and loneliness. Surprisingly, the role of memory for emotions in social integration has been overlooked. The present study examined the relationships among facial affect recognition and memory, empathy, and social outcomes after complicated-mild to severe TBI. Method: Participants were adults with complicated-mild to severe TBI (n = 53) and neurologically-healthy adults (NHA; n = 64). Main measures included the Facial Recognition and Memory for Emotions (FRAME)—a novel task measuring emotion perception and memory for facial affect—and self-report questionnaires assessing empathy and social integration outcomes including community integration, companionship, emotional support, social isolation, and loneliness. Group comparisons were conducted, and correlations evaluated the relationships among facial affect recognition and memory, empathy, and social integration outcomes. Multiple regression analyses investigated facial affect recognition, facial affect memory, and empathy as predictors of social integration outcomes. The moderating effect of awareness of deficit on the relationship between memory for emotions and social integration was analyzed via subgroup correlations and by Hayes’ PROCESS. Results: Overall, NHA exhibited better facial affect recognition and memory, as well as higher empathy levels than people with TBI, although cognitive empathy did not differ between groups, whereas affective empathy was significantly lower among persons with TBI. In terms of predicting social integration outcomes, cognitive empathy played a significant role in fostering community integration and reducing social isolation. Affective empathy, however, was primarily associated with loneliness, highlighting its role in subjective feelings of disconnectedness. There were no meaningful individual linear relationships between facial affect recognition and memory and social integration outcomes among the overall TBI group. However, multiple regression analyses indicated that memory for emotions showed an inverse relationship with social isolation and loneliness when combined with low empathy. Additionally, when self-awareness was examined as a moderator of the relationship between social integration outcomes and memory for emotions, there were significant associations among participants with impaired self-awareness via subgroup correlations; however, given small subgroup sizes, the Hayes’ PROCESS analyses were underpowered to detect interactions except for community integration. Unexpectedly, among NHA, there was an inverse relationship with memory for emotions and community integration. Conclusions: Memory for facial emotions and empathy are unique aspects of social cognition. Partial support was found for the associations of memory for emotions and empathy’s relationships with social integration outcomes. Both subjectively-experienced empathy and objective accuracy in recognizing and remembering emotions were associated with social integration, although the pattern of those relationships was complex and depended on cognitive status. Among adults with TBI, cognitive empathy but not affective empathy was positively associated with social integration outcomes including community integration, companionship, and emotional support; these associations were not observed among NHA. Additionally, among people with TBI, the combination of low empathy and low memory for emotions was associated with social isolation and loneliness. Noteworthy, among individuals with impaired self-awareness, memory for emotions appeared uniquely important for fostering meaningful social connections. The findings highlight the nuanced dynamic between emotion processing, social interaction, empathy, and awareness of deficits, providing insights regarding developing tailored interventions to support persons with TBI in navigating social interventions and enhancing emotional well-being.
Recommended Citation
Broomfield, Robiann Rushell, "The Relationship Of Empathy And Memory For Emotions With Social Integration Following Traumatic Brain Injury" (2024). Wayne State University Dissertations. 4070.
https://digitalcommons.wayne.edu/oa_dissertations/4070