The expression of emotions in Alzheimer’s disease and other dementias: An analysis of the deterioration patterns and compensatory strategies

Cognitive impairment is common in multiple sclerosis (MS) and affects daily functioning. Compensatory cognitive strategies can help mitigate these challenges, but their naturalistic use and predictors remain unclear. This study aimed to examine the frequency and types of strategies used and to determine whether demographics, objective cognitive function, or perceived cognitive function are independently associated with the use of compensatory strategies. A secondary analysis of baseline data from 268 people with MS was conducted. Compensatory cognitive strategy use was assessed via the Compensatory Cognitive Strategies Scale, perceived cognitive function via the PROMIS Cognitive Function Abilities Short Form, and objective cognitive function via the NIH Toolbox Cognitive Battery. Descriptive statistics characterized compensatory strategy use. A hierarchical linear regression analysis was performed to identify significant predictors of compensatory cognitive strategy use. Participants (mean age = 50.8 ± 11.9 years, 77.2 % female) most frequently used electronic reminders (86.6 %), established routines (83.6 %), and broke tasks into smaller steps (84.7 %), while work-related strategies were the least utilized. Lower perceived cognitive function (β = -0.232, p < .01) and walking disability (β = 0.182, p < .01) were significantly associated with greater compensatory strategy use. Perceived cognitive function, rather than objective cognitive function, was associated with compensatory cognitive strategy use. Neuropsychological assessments should identify individuals who are cognitively impaired, especially those unaware of their deficits, to provide guidance on effective strategies. Future research should evaluate compensatory cognitive strategy training to improve long-term functional independence in MS.

Most of the work conducted on figurative language in the discourse of people with dementia has been focused on their comprehension ability (Brundage & Bookshire, 1995; Chapman, Ulatowska, Franklin, Shobe, Thompson & McIntire, 1997; Papagno, 2001; Amanzio, Geminiani, Leotta & Cappa, 2008). However, there are not many studies analyzing how people suffering from this syndrome introduce this type of constructions. Bearing this in mind, this work presents the following aims: (i) to identify the different types of figurative language people with dementia use; (ii) to verify whether the frequency of use of figurative language decreases as the cognitive decline progresses; (iii) to detect how the use of figurative language can work as a compensatory strategy to hide the deficits caused by dementia. In order to do so, a corpus with videos from 23 people suffering from different forms of dementia and in different stages of the disease was compiled. The types of figurative language they introduce as well as their frequency of use have been analyzed. The results show that, even if there is a decline in their frequency of use, people with dementia still utilize figurative language until the final stage of the disease. Moreover, they resort to both discursive extenders and rhetoric language as a compensatory strategy, particularly during the moderate stage.

Impaired detection and differentiation of briefly presented facial emotions in adults with high-functioning autism and asperger syndrome

Figurative and extended uses of language are nonliteral utterances such as irony, sarcasm, and idioms and comprise a core part of social interaction. Children with typical development (TD) show a progressive adultlike understanding of figurative language around the age of ten. In contrast, individuals with neurodevelopmental disorders such as autism spectrum disorder (ASD), attention deficit and hyperactivity disorder (ADHD), or developmental language disorder often display difficulties with figurative language. However, these difficulties are a puzzle in that the actual underlying causes remain unclear. Those individuals who struggle with understanding figurative language need support through effective interventions. These should be based on solid research findings, which is often problematic as research in this field is characterized by conflicting and incomplete findings. The intention of this study is to conduct a literature review of both available studies and those intervention programs that seek to improve figurative language abilities in these atypical populations. This review will not only provide an overview of available intervention programs but also reveal the research gaps through critically appraising earlier studies. This is done as, in a manner of speaking, research reflects our theoretical understanding of the topic at hand, while interventions reflect the ways in which they are manifested into practice. This will serve to give the reader a more complete overview of the state of knowledge on figurative language and neurodevelopmental disorders. This article may be read for an overview of the field, but it also aims to point out the areas where additional research is needed. For instance, while figurative language takes many forms, there is a disproportionate scholarly focus on metaphors compared to other types. We will ultimately highlight promising approaches and make suggestions for future directions in terms of research and practice.

Event Abstract Back to Event High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder. Hannah M. Hobson1* and Geoffrey Bird2, 3 1 University of Greenwich, United Kingdom 2 University of Oxford, United Kingdom 3 Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom Developmental Language Disorder (DLD) is a neurodevelopmental condition in which children do not achieve typical levels of language skill. These children may experience difficulties with structural aspects (i.e. syntactic, lexical and phonological problems) as well as pragmatic aspects of language. The prevalence rate of DLD is approximately 7.5% (Norbury et al., 2016). Thus, in a typical UK classroom of 30 students, we can expect on average two children to have DLD. Despite its relative prevalence compared to more widely known conditions such as autism (which has an estimated prevalence of around 1%; Baird et al., 2006), DLD is not well known. This is partly due to a historic lack of agreement on the criteria and terminology for DLD; recent efforts have been made to reach consensus on these issues (Bishop et al., 2016). However, the goal of increased awareness of DLD is not yet reached, and in the meantime, poor awareness of DLD has implications for children’s wellbeing and long-term outcomes. It is unsurprising, given the oral language and literacy demands of most education systems, that children with DLD show poorer academic outcomes compared to typically developing children (Johnson, Beitchman, & Brownlie, 2010). However, children with DLD may also face problems with their attendance: children who are school-refusers have poorer language skills overall, and a higher incidence of language impairments (Naylor, Staskowsi, Kenney & King, 1994). Language problems are also associated with exclusions from school; excluded children show higher rates of expressive language difficulties (Ripley & Yuill, 2005), and studies of mainstream secondary school pupils facing exclusion suggest that two thirds have language problems, with one third showing severe language problems (Clegg, Stackhouse, Finch, Murphy, & Nicholls, 2009). Of the 15 children assessed for this study, only one had received speech and language therapy (for a stammer); none of the other children had been assessed by a speech and language therapist. All children had been excluded three or more times, and were at risk of being permanently excluded from school. Language impairment is also elevated in mental health services. The high rate of language problems in children and adolescents accessing support for emotional and behavioural problems has been summarised in a meta-analysis of 22 studies (Hollo, Wehby, & Oliver, 2014): approximately 81% of children accessing help for an emotional-behavioural disorder have below-average language proficiency, and that 47% of children show moderate to severe language problems. None of the children in the studies had previously been assessed for speech or language problems. As yet, there is no data to indicate whether the high rate of language problems in these services has an impact on progress in psychological therapy. Language problems also show relationships to involvement with the criminal justice system. Language-impaired youth have higher rates of arrests and convictions (Brownlie et al., 2004), and the rate of language impairment in young offender institutions is elevated (see Anderson, Hawes, & Snow, 2016 for a systematic review). A recent study found that 47% of the 93 young offenders assessed showed language skills significantly below what would be expected for their age, and 20% would have met the criteria for language impairment (Hughes et al., 2017). The majority of those identified as having a language impairment had not previously worked with a speech and language therapist. It is thus clear that in a variety of different vulnerable populations we see higher rates of language impairment than would be expected given the prevalence in the general population, and that many of these cases go undetected. It is important to emphasise that many children with DLD go on to have good outcomes, and that language impairment is not deterministic of the problems discussed here (see Johnson et al, 2010). This is important, as it suggests firstly that there are factors that moderate the relationship between language problems and wellbeing, and secondly because it offers hope that, with appropriate identification and support, children with DLD can have good outcomes. Nonetheless, a pertinent question is why are rates of DLD increased across these different settings? There are number of plausible reasons. Firstly, some of the risk factors for poor language development and emotional and behavioural problems are overlapping, such as social disadvantage (Horwitz et al., 2003; Olak et al., 2009; Singh & Ghandour, 2012). Secondly, language problems themselves may contribute to social and psychological difficulties that increase the risk of emotional and behaviour problems. Specifically, language problems may lead children to experience social isolation, reducing opportunities for acquiring good social skills and increasing the risk of poor self-esteem and poor emotional outcomes (Craig, 1993; Redmound & Rice, 1998; Wadman, Durkin, & Conti-Ramsden, 2008). Children with language problems are also at increased risk of being bullied (Redmond, 2011), and of having poorer emotion regulation (Fujiki, Brinton & Clarke, 2002). Finally, and of relevance to an array of different professions, when their language problems are not recognised, the behaviours of children and young people with DLD may be interpreted by the adults in their environment in a way that increases the likelihood of poor outcomes. In the context of forensic interviewing, Snow and Powell (2012) argue that the presentation of language problems in young offenders may lead professionals to assume that the young person is rude, or incoherent with their account of events (and therefore likely guilty). One account given by a young person in prison stated that when asked by a judge if he was remorseful of his crime, he said no: he had never heard the word “remorseful” before, and had no idea what it meant (Talbot, 2007). If such an experience is representative of young people with communication disorders’ interactions with the criminal justice system, it is perhaps not surprising that the rate of language problems is so high in young offender institutions. Extrapolating this to the headteacher’s office or the psychiatrist’s chair, we may predict that children with DLD are similarly judged as being uncooperative, unapologetic or reticent. It would be naïve to assume that untrained professionals will readily detect language problems in their cohorts. Rather, language impairments will not always be obvious to people interacting with a person with DLD; adults have a tendency to assume that children understand more of what is being said to them than is actually the case (Sattler, Feldman, & Bohanan, 1985), and children may engage in masking behaviours that cover their language problems (Evans & Macwhinney, 1999). Indeed, teachers have quite poor sensitivity and specificity to children’s oral language impairments (Antoniazzi, Snow & Dickson-Swift, 2010). Even in settings where we might expect educational staff to have a higher level of knowledge regarding language problems, this is not necessarily the case: in a special school for children with emotional and behavioural difficulties in which the prevalence of language impairment was 74%, less than half of these children had been identified as impaired (Stringer & Lozano, 2007). Speech problems may be the most detectable issue, but children with pure speech problems actually do not show adverse outcomes, compared to typical children (Johnson et al., 2010). Possibly this is because speech problems do not affect children’s social and emotional development in the same way that a language problem does. Alternatively, perhaps a child with a speech problem is far more likely to be identified and supported than a child who has a language impairment but whose speech does not sound unusual. What happens to these children and young people if their language problems are not recognised? The increased rates of language impairment in children facing exclusion from school and in the criminal justice system paint a gloomy picture. DLD is considered a lifelong condition, and while children’s language skills may improve, they require input from specialists to help them acquire skills and strategies to compensate for their language problems (Perkins, 2001). Clearly there are many children who finish schooling and enter services aiming to remediate mental health problems or criminal behaviours without their language problems having been detected. It is therefore important that awareness of DLD is sufficient in professions that are very likely to interact with children with DLD, including mental health and forensic professionals. Acknowledgements Geoff Bird was supported by the Baily Thomas Charitable Trust. References Anderson, S. A. S., Hawes, D. J., & Snow, P. C. (2016). Language impairments among youth offenders: A systematic review. Children and Youth Services Review, 65(April), 195–203. http://doi.org/10.1016/j.childyouth.2016.04.004 Antoniazzi, D., Snow, P., & Dickson-Swift, V. (2010). Teacher identification of children at risk for language impairment in the first year of school. International journal of speech-language pathology, 12(3), 244-252. Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., & Charman, T. (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet, 368(9531), 210–215. http://doi.org/10.1016/S0140-6736(06)69041-7 Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., Adams, C., Archibald, L., … Whitehouse, A. (2016). CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children. PLoS ONE, 11(7), 1–26. http://doi.org/10.1371/journal.pone.0158753 Brownlie, E. B., Beitchman, J. H., Escobar, M., Young, A., Atkinson, L., Johnson, C., ... & Douglas, L. (2004). Early language impairment and young adult delinquent and aggressive behavior. Journal of abnormal child psychology, 32(4), 453-467. Clegg, J., Stackhouse, J., Finch, K., Murphy, C., & Nicholls, S. (2009). Language abilities of secondary age pupils at risk of schoolClegg, J., Stackhouse, J., Finch, K., Murphy, C., & Nicholls, S. (2009). Language abilities of secondary age pupils at risk of school exclusion: A preliminary report. Child Language Teaching and Therapy, 25(1), 123–139. http://doi.org/10.1177/0265659008098664 Craig, H. K. (1993). Social skills of children with specific language impairment: Peer relationships. Language, Speech, and Hearing Services in Schools, 24(4), 206-215. Evans, J. L., & MacWhinney, B. (1999). Sentence processing strategies in children with expressive and expressive-receptive specific language impairments. International Journal of Language & Communication Disorders, 34(2), 117-134. Fujiki, M., Brinton, B., & Clarke, D. (2002). Emotion regulation in children with specific language impairment. Language, Speech, and Hearing Services in Schools, 33(2), 102-111. Hollo, A., Wehby, J. H., & Oliver, R. M. (2014). Unidentified language deficits in children with emotional and behavioral disorders: A meta-analysis. Exceptional Children, 80(2), 169–186. http://doi.org/10.1177/001440291408000203 Horwitz, S. M. C., Irwin, J. R., Briggs-Gowan, M. J., Bosson Heenan, J. M., Mendoza, J., & Carter, A. S. (2003). Language delay in a community cohort of young children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(8), 932–940. http://doi.org/10.1097/01.CHI.0000046889.27264.5E Hughes, N., Chitsabesan, P., Bryan, K., Borschmann, R., Swain, N., Lennox, C., & Shaw, J. (2017). Language impairment and comorbid vulnerabilities among young people in custody. Journal of Child Psychology and Psychiatry and Allied Disciplines, 58(10), 1106–1113. http://doi.org/10.1111/jcpp.12791 Johnson, C. J., Beitchman, J. H., & Brownlie, E. B. (2010). Twenty-year follow-up of children with and without speech-language impairments: Family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology, 19(1), 51–65. http://doi.org/10.1044/1058-0360(2009/08-0083) Naylor, M. W., Staskowski, M., Kenney, M. C., & King, C. A. (1994). Language disorders and learning disabilities in school-refusing adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 33(9), 1331-1337. Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., … Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 57(11), 1247–1257. http://doi.org/10.1111/jcpp.12573 Amone-P’Olak, K., Burger, H., Ormel, J., Huisman, M., Verhulst, F. C., & Oldehinkel, A. J. (2009). Socioeconomic position and mental health problems in pre-and early-adolescents. Social psychiatry and psychiatric epidemiology, 44(3), 231-238. Perkins, M. R. (2001). Compensatory strategies in SLI. Clinical Linguistics and Phonetics, 15(1–2), 67–71. http://doi.org/10.1080/026992001461334 Redmond, S. M. (2011). Peer victimization among students with specific language impairment, attention-deficit/hyperactivity disorder, and typical development. Language, Speech, and Hearing Services in Schools, 42(4), 520-535. Redmond, S. M., & Rice, M. L. (1998). The socioemotional behaviors of children with SLI: Social adaptation or social deviance?. Journal of Speech, Language, and Hearing Research, 41(3), 688-700. Ripley, K., & Yuill, N. (2005). Patterns of language impairment and behaviour in boys excluded from school. The British Journal of Educational Psychology, 75(Pt 1), 37–50. http://doi.org/10.1348/000709905X27696 Sattler, J. M., Feldman, J., & Bohanan, A. L. (1985). Parental estimates of children’s receptive vocabulary. Psychology in the Schools, 22(3), 303–307. http://doi.org/10.1002/1520-6807(198507)22:3<303::AID-PITS2310220312>3.0.CO;2-J Singh, G. K., & Ghandour, R. M. (2012). Impact of neighborhood social conditions and household socioeconomic status on behavioral problems among US children. Maternal and Child Health Journal, 16(SUPPL. 1), 158–169. http://doi.org/10.1007/s10995-012-1005-z Snow, P., & Powell, M. (2012). Youth (in) justice: Oral language competence in early life and risk for engagement in antisocial behaviour in adolescence. Trends and Issues in Crime and Criminal Justice, 435, 1-6. Stringer, H., & Lozano, S. (2007). Under identification of speech and language impairment in children attending a special school for children with emotional and behavioural disorders. Educational & Child Psychology, 24(4), 9–19. Talbot, J. (2007) No One Knows: Identifying and Supporting Prisoners with Learning Difficulties and Learning Disabilities. The Views of Prison Staff. London: Prison Reform Trust Wadman, R., Durkin, K., & Conti-Ramsden, G. (2008). Self-esteem, shyness, and sociability in adolescents with specific language impairment (SLI). Journal of Speech, Language, and Hearing Research, 51(4), 938-952. Keywords: developmental language disorder (DLD), Language, vulnerable population group, Mental Health, Policy & disabilities Conference: 4th International Conference on Educational Neuroscience, Abu Dhabi, United Arab Emirates, 10 Mar - 11 Mar, 2019. Presentation Type: Oral Presentation (invited speakers only) Topic: Educational Neuroscience Citation: Hobson HM and Bird G (2019). High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder.. Conference Abstract: 4th International Conference on Educational Neuroscience. doi: 10.3389/conf.fnhum.2019.229.00002 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 08 Feb 2019; Published Online: 27 Sep 2019. * Correspondence: Dr. Hannah M Hobson, University of Greenwich, Greenwich, London, SE10 9LS, United Kingdom, H.Hobson@greenwich.ac.uk Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Hannah M Hobson Geoffrey Bird Google Hannah M Hobson Geoffrey Bird Google Scholar Hannah M Hobson Geoffrey Bird PubMed Hannah M Hobson Geoffrey Bird Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

BackgroundChildren with speech, language, and communication disorders require specialized support in response to their emotional expression challenges. Not only is such support key for their development, but it is also essential for their mental well-being. Art making emerges as a valuable tool for enabling these children to convey emotions both verbally and non-verbally, fostering a positive self-concept. School-based arts interventions have the potential to improve self-concept and emotional expression, and more generally, the quality of life. However, there is limited empirical evidence regarding the feasibility, acceptability, and perceived effectiveness of a manualized, school-based creative arts intervention for this specific group.AimThis study aimed to develop and evaluate the feasibility, acceptability, and perceived benefits of an art-based intervention for elementary school students with speech, language, and communication disorders, using qualitative methods to obtain diverse perspectives.ResultsThe findings indicate that the intervention was feasible and well received, as reported by teachers, students, and facilitators. Participants also discussed potential positive outcomes, including emotional expression, emotional growth, and fulfilment of autonomy, competence, and relatedness needs. Students found the workshops conducive to sharing emotions and took pride in the creative process. Teachers gained deeper insights into their students, fostering positive classroom relationships. Observational data triangulated these findings.ConclusionThis innovative project suggests that art-based interventions can potentially benefit students’ emotional expression, but further experimental studies are needed to substantiate these effects.

Neuropsychological and neuroimaging studies have shown that facial recognition and emotional expressions are dissociable. However, it is unknown if a single system supports the processing of emotional and non-emotional facial expressions. We aimed to understand if individuals with impairment in face recognition from birth (congenital prosopagnosia, CP) can use non-emotional facial expressions to recognize a face as an already seen one, and thus, process this facial dimension independently from features (which are impaired in CP), and basic emotional expressions. To this end, we carried out a behavioral study in which we compared the performance of 6 CP individuals to that of typical development individuals, using upright and inverted faces. Four avatar faces with a neutral expression were presented in the initial phase. The target faces presented in the recognition phase, in which a recognition task was requested (2AFC paradigm), could be identical (neutral) to those of the initial phase or present biologically plausible changes to features, non-emotional expressions, or emotional expressions. After this task, a second task was performed, in which the participants had to detect whether or not the recognized face exactly matched the study face or showed any difference. The results confirmed the CPs' impairment in the configural processing of the invariant aspects of the face, but also showed a spared configural processing of non-emotional facial expression (task 1). Interestingly and unlike the non-emotional expressions, the configural processing of emotional expressions was compromised in CPs and did not improve their change detection ability (task 2). These new results have theoretical implications for face perception models since they suggest that, at least in CPs, non-emotional expressions are processed configurally, can be dissociated from other facial dimensions, and may serve as a compensatory strategy to achieve face recognition.

Language interventions are complex behavioural interventions, making it difficult to distinguish the specific factors contributing to efficacy. The efficacy of oral language comprehension interventions varies greatly, but the reasons for this have received little attention. The aim of this meta-analysis was to examine which intervention factors are associated with efficacy (as expressed with effect sizes) regarding interventions aiming to improve oral language comprehension on its own, or together with expressive language, in children under the age of 18 with or at risk for (developmental) language disorder-(D)LD. Whether the interventions for younger and older children differ from one another regarding efficacy or factors possibly associated with efficacy were also examined. Studies (n = 46) were identified through two systematic scoping reviews. Factors associated with efficacy were categorized according to the internal characteristics of the intervention as well as factors external to the intervention. Statistical analyses were conducted to examine the association between these factors and intervention efficacy as represented by effect sizes on oral language comprehension outcome measures. Targeting language, language environment or compensatory strategies indicated efficacy, whereas aiming to improve language processing indicated no clinically significant efficacy. Targeting only receptive language was associated with larger effect sizes than targeting both receptive and expressive language. The interventions for younger (2-7 years) and older (8-13 years) children indicated a similar degree of efficacy, but the way in which these results were achieved varied, as comprehension interventions for younger and older children differed from one another. Many factors associated with effect sizes were also associated with each other making interpretation of the results complex. These indicative results suggest that it is not reasonable to target language processing, such as auditory processing or automatization, when aiming to improve oral language comprehension. Targeting receptive language only rather than both receptive and expressive language seems preferable to maximize efficacy when aiming to support solely oral language comprehension instead of targeting both expression and comprehension. The qualitative active ingredients of treatment appear to be more important than the number of intervention hours. Although children of different ages can benefit from interventions to enhance oral language comprehension, the child's age needs to be carefully considered to develop interventions that are optimal. Further research with larger data sets regarding factors contributing to efficacy is still needed before applying these results confidently to clinical practice. What is already known on this subject Little is known about the specific intervention factors associated with efficacy of comprehension interventions, and whether these differ between children of different ages. To be able to choose and create optimal comprehension interventions, a better understanding of the mechanisms of change is needed. What this paper adds to the existing knowledge The results indicate that oral comprehension skills of children aged 2-13 years with or at risk for (D)LD can be supported. Targeting language processing, such as auditory processing or automatization, does not seem reasonable when aiming to support oral comprehension. Rather, the interventions should target children's language skills related to comprehension, their language environment or provide children with compensatory strategies. The types of interventions used with younger and older children differed, such that those used with older children were more targeted, adult-directed, applied in formal activities, as well as used taught strategies and more explicit methods of instruction. What are the potential or actual clinical implications of this work? When developing interventions for oral language comprehension, the child's age needs to be considered. Further, what is targeted in an intervention in relation to the aim of the intervention needs careful consideration. The content of the intervention (therapeutic dose form) appears to have precedence over the amount of intervention.

Vocal expression of emotions (EE) in retrieval of events from autobiographical memory was investigated in patients in early stages of Alzheimer’s disease (AD). Twenty-one AD patients and 19 controls were interviewed, and EE of the reported memories was rated by 8 independent evaluators. The AD group had lower EE of both recent and remote memory than controls, although EE in remote memories was better preserved in both groups. We observed positive correlations between EE and indicators of cognitive competence in AD patients. AD Patients are impaired in the ability to express emotions already at early stages of the disease, and EE seems to deteriorate along with the progression of cognitive impairment.

This paper examines the use of figurative language in expressing emotions in social media. Based on the analysis of 300 posts from Weibo.com, we argue that there is a close interaction between figurative language and emotion. It is found that 27% of the posts contain figurative devices such as metaphor, simile, rhetorical questions, and irony. Among the five basic emotions, the emotion of anger has the greatest tendency to be expressed via the figurative devices, followed by sadness, fear, surprise, and happiness. In addition, the data shows that rhetorical questions are the most frequently used figurative device for evoking negative emotions, i.e. anger and sadness. We believe that the linguistic account of figurative language in emotion expressions will significantly enhance the effectiveness of the existing automatic emotion classification systems.

&lt;p&gt;&lt;strong&gt;Context and relevance.&lt;/strong&gt; Social cognitive impairments in schizophrenia often hinder effective everyday communication and underscore the need for interventions grounded in natural compensatory mechanisms. &lt;strong&gt;Objective.&lt;/strong&gt; To investigate spontaneously emerging compensatory communicative strategies in patients with schizophrenia. &lt;strong&gt;Hypotheses.&lt;/strong&gt; (I) Schizophrenia patients employ compensatory communication strategies distinct from healthy controls; (II) The application of these strategies varies depending on the severity of patients&amp;rsquo; deficit symptoms. &lt;strong&gt;Methods.&lt;/strong&gt; The study employed a dyadic design. In the experimental group (30 dyads), a patient with paranoid schizophrenia collaborated with a healthy participant on a task involving the identification of characters' cognitive errors in silent film clips. Successful task performance required constructing a theory of mind for the observed character and aligning it with one&amp;rsquo;s own perception of the communicative situation. The control group included only healthy individuals (20 dyads). The relationship between three variables was examined: (1) group membership (experimental/control), (2) effectiveness in detecting the characters&amp;rsquo; cognitive errors, and (3) the use of compensatory strategies that facilitate the interpretation of communicative situations from the characters&amp;rsquo; perspective. The compensatory strategies analyzed included the integration of inferred direct speech and observed gestures of referential agents into the participant&amp;rsquo;s own narrative when retelling the situation to a partner. Patients with schizophrenia were further stratified by the severity of negative symptoms (SANS scores). &lt;strong&gt;Results.&lt;/strong&gt; Results revealed that patients with mild negative symptoms used gestural reenactments significantly more often than both patients with pronounced symptoms and healthy controls. Additionally, patients with mild negative symptoms more frequently integrated direct speech attributed to characters into their own narratives than those with severe symptoms, although they did not differ significantly from healthy participants. &lt;strong&gt;Conclusions.&lt;/strong&gt; 1. A universal compensatory strategy used by both healthy individuals and patients with schizophrenia when perceiving complex communicative situations is the incorporation of presumed character utterances into their own speech. Among patients with schizophrenia, the use of this strategy tends to decline as negative symptoms become more severe. 2. A specific compensatory mechanism observed in patients with schizophrenia is the use of gestures when describing the behavior of perceived characters in complex communicative situations.&lt;/p&gt;

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This study investigates the meanings associated with the song “Scaredy Cat” by Ian DPR, focusing on connotative and denotative aspects through a semantic perspective. Using qualitative research methods, this work builds on existing research related to figurative language. The findings highlight the complex interaction between the song's literal meaning and its deeper emotional implications, which collectively enhance its impact. Denotative aspects provide a clear understanding of the songwriter's experience, while connotative elements invite deeper engagement with themes of fear, anxiety, and vulnerability. This research reveals that figurative language, such as metaphors and imagery, contributes to the layered interpretation of songs. This complexity not only strengthens the emotional bond between the artist and the audience but also encourages listeners to reflect on their own feelings and experiences. The importance of language in music as a means of expressing human emotions is emphasized. By combining empathetic language and figurative language, songwriters can create a sense of release and emotional connection. The results align with previous research on the importance of figurative language in enhancing lyrical meaning and emotional resonance. Further research is recommended to explore the relationship between semantics and emotional expression across various music genres.

Figurative language can take many forms, and its meaning is not always dictated by its constituent parts. This study aims to examines the use of figurative language in Bruno Major's song The Show Must Go On, as well as how metaphor and symbolism provide emotional depth to the lyrics' depiction of heartbreak. Music serves as a medium for both entertainment and emotional expression. Figurative language is important in shaping how the lyrics are perceived by the listener. This study seeks to examine "how metaphor and symbolism enhance the emotional depth of heartbreak in the song" and "how many metaphor and symbolism are found in the lyrics."The purpose of this study is to analyze the use of metaphors and symbolism in the lyrics of the song The Show Must Go On by Bruno Major. The qualitative research employs a method to examine the lyrics line. The data was gathered by listening to the song and categorizing the metaphor (implied, visual, extended) and symbols (object, people, color, circumstance). The study found that metaphor was commonly used in lyrics, particularly visual metaphors. Symbolism appeared second, with the majority of symbolism being object-based. The researchers find that metaphor and symbolism have an important role in increasing the emotional depth of sadness in the songs. These findings serve as a good reference for English teachers, students, and song listeners who are interested in how figurative language affects emotional depth. The song The Show Must Go On combining multiple figures of speeches that help shaping the lyrics more unique and expressing deeper emotion to the listener. The songwriter uses two figure of speeches such as metaphor and symbolism in order to shape the emotion in the song lyrics. By using these two figures of speeches, Bruno able to evoke a deeper heartbreak emotion of the character. The two figures of speeches were found on the lyrics. There are three types of metaphor found in the lyrics, such as implied, visual, and extended metaphor, and the symbolism found were , object people, and situation symbolism, while colour symbolism was not found in the lyrics.

The ability to recognize facial identity and emotional facial expression is central to social relationships. This paper reviews studies concerning face recognition and emotional facial expression during normal aging as well as in neurodegenerative diseases occurring in the elderly. It focuses on Alzheimer's disease, frontotemporal and semantic dementia, and also Parkinson's disease. The results of studies on healthy elderly individuals show subtle alterations in the recognition of facial identity and emotional facial expression from the age of 50 years, and increasing after 70. Studies in neurodegenerative diseases show that - during their initial stages - face recognition and facial expression can be specifically affected. Little has been done to assess these difficulties in clinical practice. They could constitute a useful marker for differential diagnosis, especially for the clinical differentiation of Alzheimer's disease (AD) from frontotemporal dementia (FTD). Social difficulties and some behavioural problems observed in these patients may, at least partly, result from these deficits in face processing. Thus, it is important to specify the possible underlying anatomofunctional substrates of these deficits as well as to plan suitable remediation programs.