Preserved rapid conceptual processing of emotional expressions despite reduced neuropsychological performance following traumatic brain injury

Objective: Emotional empathy is critical to successful social interactions and is often compromised after traumatic brain injury (TBI). Using the Emostroop task, we investigated whether adults with moderate to severe TBI (N = 26) have problems with rapid conceptual processing of emotional stimuli compared with controls (N = 30). Further, we investigated whether rapid conceptual processing of emotions relates to emotion recognition and emotional empathy. Method: In the Emostroop task, participants categorize emotional words (e.g., joyous, furious, and woeful) into three emotion categories: happy, sad, and angry. Each word is superimposed onto an image of a face, which expresses an emotion that is congruent to the word (congruent condition), incongruent to the word (incongruent condition), or is neutral (neutral condition). Slowed responding in the incongruent condition (interference) and speeded responding in the congruent condition (facilitation) indicates rapid conceptual processing of the faces. Participants also completed an emotion perception task, an empathy questionnaire (the BEES) and neuropsychological tests measuring processing speed, working memory, and executive function. Results: Contrary to our hypotheses, we found that rapid conceptual processing of emotional faces was preserved in people with TBI, despite diminished neuropsychological performance, emotion recognition, emotional empathy, and slowed responding. Further, the Emostroop effect was not correlated with self-reported emotional empathy or with emotion recognition. Conclusions: We conclude that in people with TBI, reduced empathy may be explained by processes downstream of the initial rapid conceptual processing of emotional information, such as flexibly attending and responding to this information in a goal-directed manner in complex environments.