19 September 2014

People with facial paralysis perceived as unhappy

The face plays a very important role in everyday communication, and people may hold a prejudice against those with facial paralysis because of their disability.

People with facial paralysis are perceived as being less happy simply because they can’t communicate in the universal language of facial expression, a new study from an Oregon State University psychology professor shows.

Addressing the stigma

The findings highlight the important role the face plays in everyday communication and indicates people may hold a prejudice against those with facial paralysis because of their disability, said Kathleen Bogart, an assistant professor of psychology in the College of Liberal arts at Oregon State University.

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“People are more wary and more likely to form a negative impression of someone with a disability,” Bogart said. “Identifying that stigma is the first step to addressing it.”

Bogart specializes in research on ableism, or prejudice about disabilities. Much of her work focuses on the psychosocial implications of facial movement disorders such as facial paralysis and Parkinson’s disease, which affect more than 200,000 Americans each year.

“Facial paralysis is highly visible,” Bogart said. “Everyone notices there’s a difference, but people have no idea why. They don’t understand the nature of the condition.”

Some basic facial expressions, including the smile, are communicated universally across cultures. But people with facial paralysis or other facial movement disorders may not be able to participate in that communication because they lack emotional expression and may seem unresponsive in social situations.

Different types of communication

To better understand how those with facial paralysis are perceived by those without facial paralysis, Bogart conducted an experiment comparing how emotions are perceived based on different forms of communication.

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About 120 participants, none of whom had facial paralysis, watched or listened to videos of people with varying degrees of facial paralysis and were asked to rate the subject’s emotions as the person recounted happy or sad experiences.

Participants were assigned to videos highlighting several communication channels, including video of just the person’s face; video of the person’s face and body; or voice-only audio with no video; as well as combinations of different types of communication.

Those with severe facial paralysis were rated as less happy than those with milder facial paralysis across all the different communication types and combinations. Those with severe facial paralysis were also rated as less sad than those with milder facial paralysis.

The findings confirmed that people with facial paralysis experience stigma, but it also confirmed that people often rely on a combination of communication channels to perceive emotions, Bogart said.

Other communication cues

That’s important because people with facial paralysis can adapt other communication channels, such as tone of voice or gestures, to enhance their communication ability, she said. Also, people interacting with someone with facial paralysis can be more watchful of other communication cues that might indicate emotion, she said. 

“It’s not all about the face,” Bogart said. “Studies like this tell us more about the way people communicate, verbally and non-verbally.” 

Her findings were published recently in the journal Basic and Applied Social Psychology. Co-authors of the study are Linda Tickle-Degnen of Tufts University and Nalini Ambady of Stanford University. The research was supported by a grant from the National Institutes of Health.

Bogart is now studying ways to help people with facial paralysis use compensatory strategies to improve communication. She has developed a social skills workshop for teenagers with facial paralysis and hopes to do more work like that in the future.

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“We know these strategies work, so let’s teach people to use those skills more,” she said. “A lot of people with facial paralysis do just fine, but there are some people who would like help or support.”

Making people aware of the stigma about facial paralysis and educating them about the causes and effects is the biggest key to reducing existing misconceptions and prejudices, Bogart said.

“People need to be able to recognize facial paralysis, and understand that they may need to pay more attention to communication cues beyond facial expression,” she said.

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Michael Simpson has been a senior psychiatric academic, researcher, and Professor in several countries, having worked at London University in the UK; McMaster University in Canada; Temple University in Philadelphia, USA.; and the University of Natal in South Africa.

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