The impact of clinical history on recognising emotional facial expressions

Abstract Introduction: Several studies have shown the importance of the role of context in recognizing facial expressions of emotion, but there are not many studies in clinical and health contexts that analyze how this influence takes place, particularly in mixed emotional expressions. Objective: Our aim is to verify whether and how the clinical condition (e.g. depression) associated with clinical history influences the interpretation of facial expressions by clinical psychologists, especially in cases of mixed emotional signs. Method: In the Method, a questionnaire was constructed with sociodemographic questions and 7 groups of questions pairing images (7) and contexts (3), for a total of 21 image-text combinations. The images are prototypical emotional expressions of 3 basic emotions (anger, fear, and sadness) and mixed expressions of these. The texts are clinical information and constitute the different contexts. Through the digital platform with the questionnaire, the order of presentation of the clinical stories and associated questions was randomized. In an intra-subject design, 60 participants, clinical psychology professionals, were assigned to three experimental conditions (story concordant with emotion; non-concordant story; and neutral story) and 21 image-text combinations, and were asked to judge the presence of the emotions studied in each combination. Results: The results showed an increase in the recognition of the facial expressions of anger and fear in the presence of a clinical history concordant with the emotion compared to the other contexts. In the mixed signals there was: greater recognition of anger (as non-dominant) in the presence of the neutral story than in the story agreeing with the dominant emotion (sadness); greater recognition of sadness (as non-dominant) in the presence of the story agreeing with fear than in the neutral story; an increase in the attribution of anger in images in which it is not present and the dominant emotion is fear, in a context of aggression vs. a neutral context. Conclusion: We conclude that our study shows that the history of the clinical condition (clinical context) has an impact on the overvaluation or undervaluation of a facial expression of emotion, and that the presence of mixed signals accentuates this contextual effect, when we refer to sadness, fear and anger.