Sex differences in response to emotion recognition training after traumatic brain injury

ABSTRACT

Objective: To examine sex differences in the effectiveness of a Stories intervention for teaching affect recognition in people with a traumatic brain injury (TBI).

Setting: Post-acute rehabilitation facilities.

Participants: 203 participants (53 women and 150 men) with moderate to severe TBI were screened. 71 were eligible and randomized to one of three treatment conditions: two affect recognition conditions and an active control (cognition). This paper examines sex differences between the Stories intervention (n = 23, 5 women and 18 men) and the cognitive treatment control (n = 24, 8 women and 16 men).

Design: Randomized controlled trial with immediate, 3- and 6-month follow-up post-tests. Interventions were 9 hours of computer-based training with a therapist.

Measures: Facial Affect Recognition (DANVA2-AF); Emotional Inference from Stories Test (EIST).

Results: A significant treatment effect was observed for the Stories intervention for women, who demonstrated and maintained improved facial affect recognition. In contrast, males in our sample did not benefit from the Stories intervention.

Conclusion: This positive finding for the Stories intervention for females contrasts with our conclusions in a previous paper, where an analysis collapsed across sex did not reveal an overall effectiveness of the Stories intervention. This intervention warrants further research and development.

KEYWORDS:

• Emotion recognition
• sex
• affect
• traumatic brain injury
• RCT
• treatment

Supplementary material

Supplemental data for this article can be accessed here.

Acknowledgments

The authors are indebted to R.C. Gur and colleagues for permission to use their pictures of facial affect in our training program.

Conflict of Interest

There is a possibility that the software package that delivers the intervention described in this study may be released in the future through a publishing company to enable dissemination of the intervention into clinical practice. If this occurs, authors of the article may receive royalty payments associated with sales of the software.

Ethical Standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Funding

Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133G080043).