Does HIV Cause People to Misinterpret Facial Expressions?

There have been many advances in HIV treatment in the past few decades. This has led to a longer average life span for people living with HIV, but can also lead to longer periods of impairment. Among the many negative outcomes of HIV is neurocognitive impairment. In fact, almost half of those with HIV will have some level of neurocognitive impairment. People with the most significant deficits could experience motor function issues or behavior problems as well as cognitive challenges. This level of dysfunction is known as HAND: HIV-associated neurocognitive disorder. When individuals have HAND, they may be unable to process their emotions or accurately perceive the emotions of those around them, which can cause strain in social interactions. Facial expressions are often a person’s first clue to someone’s emotional state. To ensure harmonious social encounters, it is important to be able to effectively interpret the expressions of others. Lucette A. Cysique of the Neurology Department at St. Vincent’s Hospital in Australia wanted to find out if this type of emotional recognition function was diminished in individuals with HIV.

In a recent study, Cysique assessed 25 HIV-negative and 85 HIV-positive individuals for neurological functioning, behavioral patterns, daily activity independence, and overall psychiatric state. She then recorded their responses to facial cues, including happy, sad, angry, fearful, and neutral faces. Cysique looked specifically at how depression, apathy, and dependence on others contributed to their responses. She found that the HIV-positive individuals who did not have HAND had minimal deficits in emotional processing abilities. However, those with HAND had significant difficulty processing the emotional states of the cues. In particular, it took them longer to identify negative facial expressions, such as anger, sadness, and fear. Also, all of the participants had trouble assessing the levels of happiness exhibited in the happy faces, but this was especially challenging for the participants with HAND. She did not find evidence to support any link between depression, independence, and apathy in emotional processing deficits.

Cysique believes that her findings give new insight into the neurocognitive degeneration that can occur as HIV advances. Evidence of this is the fact only expression identification is impaired in all HIV-positive participants, but speed of identification is reduced significantly in those with HAND. “This result indicates that the mild reduction observed in the entire group may reflect early abnormalities that are amplified with the development of clinically meaningful forms of cognitive impairment,” Cysique said, adding that she hopes future work will extend her findings by using larger sample sizes and including additional facial expressions not included in this research.

Reference:
Lane, Tammy A., Danielle M. Moore, Jennifer Batchelor, Bruce J. Brew, and Lucette A. Cysique. Facial emotional processing in HIV infection: Relation to neurocognitive and neuropsychiatric status. Neuropsychology 26.6 (2012): 713-22. Print.

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  • Lana

    Lana

    November 29th, 2012 at 12:09 PM

    Another setback to those with HIV I guess..With so much going against them this is an added burden..Also,because this has so much to do with social functioning,it is bound to have an effect in other parts of their lives too.I just hope there is help for this particular aspect of HIV.

  • Brogan

    Brogan

    November 29th, 2012 at 12:18 PM

    Look, the way that I see it is that if you are facing a terminal illness and having to come to terms with this being your ultimate fate, and you are carrying a great deal of depression around with you as a result, you might have a hard time reading facial expressions. I can see when you are feeling like this that one could certainly project their own emotions onto others, even when there is little evidence to support that kind of reading. Living with a disease such as HIV can be devastating for anyone, even for those who are trying to make the most of the fate that they khave been given. To expect them to be otherwise happy go lucky I think is doing them a great disservice. We should expect them to face their illness, yes, but they don’t have to ve cheerful all the time because I sure know that I wouldn’t be.

  • AQ

    AQ

    November 29th, 2012 at 3:29 PM

    Do the brain scans of these individuals show similarity to those from people who have the same issue minus the HIV? That could have the answer to a very valuable point that Brogan has raised in the comments here.

  • alton r

    alton r

    November 30th, 2012 at 4:02 AM

    Really?
    Misinterpretation of facial expressions?
    This is the biggest worry that you think an HIV patient would have?

  • NATHAN

    NATHAN

    November 30th, 2012 at 6:39 AM

    Did the study identify any particular reasons why some HIV-positive individuals had more of the neurocognitive impairment than others?Because substance use can generally play a role in increasing the impairment in those with HIV. They really need to look at all the possibilities or the results will not be too accurate.

  • Mike

    Mike

    November 30th, 2012 at 7:02 AM

    @Brogan & @AQ: The study did say the emotional processing deficits were not present in the depressed, apathetic, or dependent subjects; I would surmise this includes the entire sample, though 25 HIV-free is a relatively small number to extrapolate much, and the article doesn’t specify whether those without apathy, depression or independence are HIV positive or negative. See this line:
    “She did not find evidence to support any link between depression, independence, and apathy in emotional processing deficits”

  • Jackson

    Jackson

    November 30th, 2012 at 7:39 AM

    I had no idea that neurocognitive degeneration went along with HIV. A very enlightening article.

  • elias

    elias

    November 30th, 2012 at 7:43 AM

    Nathan brings up an excellent point:

    Did the study identify any particular reasons why some HIV-positive individuals had more of the neurocognitive impairment than others?Because substance use can generally play a role in increasing the impairment in those with HIV. They really need to look at all the possibilities or the results will not be too accurate.

    Have any studies been done on the number of HIV patients who self-medicated depression with substances such as alcohol or drugs? I can only imagine it would be relatively high in that population. If so, it would make sense that neurological functioning would start to go downhill.

  • JASMINE

    JASMINE

    November 30th, 2012 at 5:48 PM

    Not only is this bad news for those with HIV because it is a neurocognitive degeneration but also because facial expression is a very important part of non-verbal communication.

    This could result in weird social interactions and even come in the way of seeking help>Why,even a conversation with a therapist would be difficult with this problem.

  • leroy p

    leroy p

    December 1st, 2012 at 2:11 AM

    there is far more problems to bother about when you have HIV than not being able to interpret people’s facial expressions…so many people completely withdraw from all form of social life,I think that is a bigger problem.also the stigma,those are some of the things that are UNDER our control and yet we have done nothing about them.this decrease in ability to recognize facial expression would come way down the list of priorities if you ask me.

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