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  • Journal of the International Neuropsychological Society, Volume 19, Issue 1
  • January 2013, pp. 34-43

Emotional Expression and Socially Modulated Emotive Communication in Children with Traumatic Brain Injury

  • Maureen Dennis (a1) (a2), Alba Agostino (a3), H.Gerry Taylor (a4) (a5), Erin D. Bigler (a6) (a7), Kenneth Rubin (a8), Kathryn Vannatta (a9) (a10), Cynthia A. Gerhardt (a9) (a10), Terry Stancin (a5) (a11) and Keith Owen Yeates (a9) (a10)
  • DOI:
  • Published online: 19 November 2012

Facial emotion expresses feelings, but is also a vehicle for social communication. Using five basic emotions (happiness, sadness, fear, disgust, and anger) in a comprehension paradigm, we studied how facial expression reflects inner feelings (emotional expression) but may be socially modulated to communicate a different emotion from the inner feeling (emotive communication, a form of affective theory of mind). Participants were 8- to 12-year-old children with TBI (n = 78) and peers with orthopedic injuries (n = 56). Children with mild–moderate or severe TBI performed more poorly than the OI group, and chose less cognitively sophisticated strategies for emotive communication. Compared to the OI and mild–moderate TBI groups, children with severe TBI had more deficits in anger, fear, and sadness; neutralized emotions less often; produced socially inappropriate responses; and failed to differentiate the core emotional dimension of arousal. Children with TBI have difficulty understanding the dual role of facial emotions in expressing feelings and communicating socially relevant but deceptive emotions, and these difficulties likely contribute to their social problems. (JINS, 2013, 18, 1–10)

Corresponding author
Correspondence and reprint requests to: Maureen Dennis, Department of Psychology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON. Canada, M5G 1X8. E-mail:
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