Fearful Faces Research Articles

Setting the tone: crossmodal emotional face-voice combinations in continuous flash suppression

Emotional stimuli are preferentially processed in the visual system, in particular, fearful faces. Evidence comes from unimodal studies with emotional faces, although real-life emotional encounters typically involve input from multiple sensory channels, such as a face paired with a voice. Therefore, in this study, we investigated how emotional voices influence preferential processing of co-occurring emotional faces. To investigate early visual processing, we used the breaking continuous flash suppression paradigm (b-CFS): We presented fearful, happy, or neutral faces to one eye, which were initially inaccessible to conscious awareness due to the predominant perception of a dynamic mask presented to the other eye. Faces were presented either unimodally or paired with non-linguistic vocalizations (fearful, happy, neutral). Thirty-six healthy participants were asked to respond as soon as the faces reached conscious awareness. We replicated earlier findings that fearful faces broke suppression faster overall, supporting a threat bias. Moreover, all faces broke suppression faster when paired with voices. Interestingly, faces paired with neutral and happy voices broke suppression the fastest, followed by faces with fearful voices. Thus, in addition to supporting a threat bias in unimodally presented fearful faces, we found evidence for crossmodal facilitation.

Embracing diversity and inclusivity in nursing: challenges and opportunities for transgender and intersex individuals in Pakistan

Variety is an integral aspect of our world, adding beauty and enabling us to appreciate the diverse qualities present in different aspects of life. Imagine a world without diversity, where we are left with only one type of fruit, flower, or colour. Such uniformity would render life bland and monotonous. Hence, the importance of diversity cannot be overstated, as it brings vibrancy and richness to our existence, making it essential for our well-being. God created diverse sexes, including female, male, intersex, and transgender individuals, each with roles to fulfil. However, intersex and transgender people often face barriers to healthcare access, professionals' unfamiliarity with relevant terminology, failure to respect patients' preferred pronouns, and treatment in non-inclusive environments [1]. Similarly, a 2024 study by Nation, Austin found that LGBT individuals often face fear, stigma, discrimination, homophobia, and even violence when seeking healthcare and mental health services [2]. Transgender individuals are underrepresented in nursing worldwide, including in Pakistan, due to fears of discrimination and social rejection, despite the profession's esteemed status. Pakistan is grappling with a severe shortage of nurses, as evidenced by the 2022-23 report from the Pakistan Nursing Council, which indicates a total enrolment of 103,821 registered nurses. In the Asian region, there has been a notable increase in the departure of nursing professionals as a result of stress, burnout, and disproportionate workloads both proceeding and during the COVID-19 pandemic [3]. To address the nursing shortage, the transgender and intersex community's potential should be recognized, given their physical and mental strength. Historically, they held roles like guards and chamberlains in the Middle East and China [4]. Transgender individuals, known for their compassion and empathy, are ideal for nursing roles. Integrating them helps address the nursing shortage, provides dignified opportunities, and reduces involvement in unethical activities like sex work and begging. Nurses should explore how to integrate transgender and intersex individuals into the profession with respect and dignity, considering eligibility, educational gaps, cultural objections, and workplace readiness. Rigorous research is needed to address these issues and ensure equal rights for all.

Perceiving emotions in the eyes: the biasing role of a fearful mouth.

The role of the eye region in interpersonal communication and emotional recognition is widely acknowledged. However, the influence of mouth expression on perceiving and recognizing genuine emotions in the eye region, especially with limited attentional resources, remains unclear. Thirty-four participants in this study completed a dual-target rapid serial visual presentation (RSVP) task while their event-related potential (ERP) data were simultaneously recorded. They were instructed to identify the type of houses and the emotional expression displayed in the eye region. The first target (T1) consisted of three upright houses, and the second target (T2) included fearful and neutral normal faces, mouth-scrambled faces, as well as composite faces (fearful eye + neutral mouth, neutral eye + fearful mouth). A robust mass univariate statistics approach was utilized to analyze the EEG data. Behaviorally, the presence of a fearful mouth facilitated recognition of the fearful eye region but hindered recognition of the neutral eye region compared to a neutral mouth. The ERP results showed that fearful expressions elicited larger N170, early posterior negativity (EPN), and P3 amplitudes relative to neutral expressions. The P1 amplitudes were increased, whereas the N170 and EPN amplitudes were reduced in response to normal and composite faces compared to mouth-scrambled faces. Collectively, these findings indicate that an unattended fearful mouth can capture covert attention and shape evaluation of eye expressions within a face, providing novel insights into the impact of visually salient mouth cues on cognitive processes involved in mind reading.

"Sentio ergo est": Unmasking the psychological realities of emotional misperception.

Perception is an important aspect of our personal lives, interpersonal interactions and professional activities and performance. A large body of psychological research has been dedicated to exploring how perception happens, whether and when it involves conscious awareness and what are the physiological correlates, such as skin-conductance and heart-rate responses, that occur when we perceive particularly emotional elicitors. A more recent and less explored question in psychological science is how and when misperception happens, and what are the physiological characteristics of the misperception of emotion. Therefore, in the current study, for the first time in relevant research, we recruited participants using trial-contour power calculations for false-positive responses, such as incorrectly reporting that a brief backward masked face was presented and thoroughly explored these responses. We reported that false-positive responses for backward masked emotional faces were characterised by pre-trial arousal, and post-trial arousal increases, high confidence ratings, and corresponding to stimulus-type misperception valence and arousal participant ratings. These outcomes were most pronounced for false-positive responses for fearful faces. Based on these findings, we discussed the possibility of a mechanism for partial self-encapsulated emotional-experiential apperception and the possibility of a fear primacy socio-emotional response module during combined visual ambiguity and high psychophysiological arousal.

Facial Expression Perception and Psychological Changes During Space Analogs.

Facial expression perception is the process by which someone can interpret the emotion of another individual using their facial cues. Below-average scores on tests designed to measure facial expression recognition (FER) accuracies are associated with inappropriate behavioral responses and are often linked to mental or neurological disorders. Head-down bed rest microgravity analog studies show changes in facial emotion processing that may indicate a behavioral health risk during spaceflight. During short-duration space analog missions at two separate facilities, 15 subjects took daily FER tests before, during, and after the mission. Each test was accompanied by questionnaires measuring either potential causal or impacted variables: stress, depression, loneliness, irritability, risk-taking, empathy, and intrinsic motivation. Analysis of variance and post hoc t-tests showed that during the mission, the subjects were less likely to identify angry, sad, or fearful faces as disgusted compared to the baseline. Also, interest/enjoyment and perceived competence increased throughout the mission lifecycle. Multiple regression analyses were able to account for greater than 20% of the variance for depression and health/safety risk-taking using the FER data. Changes in FER during space mission simulations show that perception changes are not limited to microgravity analogs. A perceptual change was observed during the short-duration missions, but there is not sufficient evidence to show behavioral health impacts. However, associations between FER and the questionnaires show a potential to develop predictive models, countermeasures, or psychological monitoring tools using FER. Additional research is required to determine the efficacy of such tools during long-duration spaceflight. Van Hoy S. Facial expression perception and psychological changes during space analogs. Aerosp Med Hum Perform. 2024; 95(12):913-918.

Age- and sex-related differences in social competence and emotion labeling in pre-adolescence.

Identification of facial expressions is important to navigate social interactions and associates with developmental outcomes. It is presumed that social competence, behavioral emotion labeling and neural emotional face processing are related, but this has rarely been studied. Here, we investigated these interrelations and their associations with age and sex, in the YOUth cohort (1055 children, 8-11 years old). Using a multistep linear modelling approach, we associated parent-reported social competence, basic emotion labeling skills based on pictures of facial expressions, and neural facial emotion processing during a passive-watching fMRI task with pictures of houses and emotional faces. Results showed better emotion labeling and higher social competence for girls compared to boys. Age was positively associated with emotion labeling skills and specific social competence subscales. These age- and sex-differences were not reflected in brain function. During fMRI, happy faces elicited more activity than neutral or fearful faces. However, we did not find evidence for the hypothesized links between social competence and behavioral emotion labeling, and with neural activity. To conclude, in pre-adolescents, social competence and emotion labeling varied with age and sex, while social competence, emotion labeling and neural processing of emotional faces were not associated with each other.

Associations Between Callous-Unemotional (CU) Traits and EmotionRecognition Abilities in School Children: The Influence of ConductProblems and Age.

Callous-unemotional (CU) traits are associated with severe conduct problems (CP) in youth. Causal theories for CU traits focus on emotion processing deficits that interfere with empathy development. However, though CU traits are consistently associated with deficits in affective empathy (i.e., emotional reactivity), the association between CU traits and cognitive empathy, which requires accurate emotion recognition, is less clear. We hypothesize that past inconsistencies in the associations between CU traits and emotion recognition may be due to interactions with conduct problems (CP) and age. To test this, a sample (N = 258) of school children in the 3rd, 6th, and 8th grades completed a computer task that assessed facial expression recognition, while caregivers and teachers reported on CU traits and CP. Results from hierarchical linear regression analyses indicated significant interactions between CU traits and CP in their associations with overall emotion recognition and with recognition of fearful and sad faces. In each case, CP showed a non-significant negative association with emotion recognition at high levels of CU traits. However, for fear and sadness recognition, CP was positively associated with accuracy at low levels of CU traits. Significant interactions between CU traits and age also emerged for recognition of fear and sadness, such that there were non-significant negative associations between CU traits and recognition accuracy in younger children, but significant positive associations in 8th grade students. These results have multiple implications as they help to clarify past inconsistencies on the association between CU traits and emotion recognition and can aid in the development of more effective interventions to prevent or treat conduct problems in young children.

Knocking Down the Pillars of Democracy in Europe: Politicisation of Science and Law in Response During COVID-19

Abstract The European Parliament has stressed on numerous occasions in public documents and speeches its non-conditional support for the principles of democracy, the rule of law, good governance, respect for human rights and fundamental freedoms. Yet as the pandemic has developed these principles have not been defended by various member states of the EU, being traded for public health and public good. This presentation seeks to critically analyse the content of key rhetoric and narratives from the outbreak of the pandemic until the present time through public statements that shall be contrasted against the “unconditional principles” above within the theoretical frame of Situational Crisis Communication Theory. Attention shall be paid to key political officials and understand the role of mainstream mass media and social media as gatekeepers of the orthodoxy of knowledge established. Orthodoxy of knowledge is group consensus on defining and constructing ‘realities’ in the physical realm, even when the consensus is coerced. Given the increasing lack of scientific debate, which is a fundamental element of good scientific practice, and the use of heavy handed and largely unsuccessful responses to the virus (such as lockdowns, vax passports and vaccination campaigns), Europe (not only) is in a precarious position in terms of its societal principles and practice. Crisis management is expediently rushed through face of fear and time constraint based upon a lack of consideration for the consequences and long-term effects, some of which are already emerging but being silenced. Hence a creeping crisis of significant psychological and physical impact is in the making.

Investigating the hemiretinal asymmetry in emotion processing as a function of spatial frequency.

The subcortical visual pathway to the amygdala has long been considered a rapid and crude stream for processing emotionally salient information that is reliant on low spatial frequency (LSF) information. Recently, research has called this LSF dependency into question. To resolve this debate, we take advantage of an anatomical hemiretinal asymmetry, whereby the nasal hemiretina sends a higher proportion of information through the subcortical pathway than the temporal hemiretina. We recorded brain activity using electroencephalography (EEG) in human participants (N = 40) while they completed a monocular viewing paradigm. Pairs of faces (one fearful and one neutral, or both neutral) were projected simultaneously to the nasal and temporal hemiretina in three contrast-equated blocks; faces filtered to display only (i) LSF, (ii) high spatial frequency (HSF), or (iii) unfiltered information (broadband spatial frequency; BSF). BSF fearful faces were found to produce a greater naso-temporal asymmetry, with greater N170 amplitudes evoked by BSF faces in the nasal field, compared to HSF faces. Conversely, the naso-temporal asymmetry for LSF fearful faces did not differ between BSF and HSF. Collectively, these findings provide crucial evidence that the subcortical pathway carries combined spatial frequency visual signals, with a potential bias against HSF content.

Contextual memory bias in emotional events: Neurobiological correlates and depression risk

BackgroundContextual memory loss of emotional events plays a critical role in depression psychopathology. Individuals with depression, clinical or subclinical, exhibit enhanced and impaired memory for emotionally negative stimuli and context in an event, respectively. This suggests that contextual encoding may fail because of attentional interference caused by concurrent negative stimuli, possibly leading to contextual memory loss as a depression risk. Amygdala–prefrontal connectivity and cortisol may underlie the mechanism; however, the relationships remain unknown. MethodsOne hundred twenty participants, including 34 with subclinical depression, underwent behavioral tasks, functional magnetic resonance imaging (fMRI) scans, and saliva collection. Encoding and 24 h later recollection performance of visuoperceptual/spatial/temporal context in a series of events, where fearful (vs. neutral) faces appeared, were measured via contextual memory tasks. Overgeneral autobiographical memory (OGM), a more remote form of contextual memory loss, was also assessed via the Autobiographical Memory Test. Amygdala connectivity was measured by fMRI during attentional interference by fearful (vs. neutral) faces to differentiate selective attention from encoding. Basal cortisol levels were assayed through saliva collected at encoding during the visit day and across 2 consecutive days in the following week (12 time points in total). We explored whether contextual memory encoding failure would explain depressive symptoms through OGM under possible moderation of amygdala connectivity and cortisol. ResultsIn individuals with subclinical depression compared to those without, fearful faces disturbed memory encoding of the visuoperceptual context rather than 24 h later recollection, while neutral faces in their temporal proximity contrastingly augmented it. The more the contextual memory encoding bias (fearful vs. neutral) intensified, the more the amygdala’s functional connectivity with the ventromedial prefrontal cortex (vmPFC) weakened. Higher total cortisol output tended to be correlated with poorer 24-h later recollection of the temporal context. Moderated mediation effects of the amygdala-vmPFC connectivity and cortisol were not significant; however, contextual encoding bias explained depressive symptoms through negatively valenced OGM. ConclusionsNegative stimuli appearing in an event might impair memory encoding of the visuoperceptual context under attentional interference, represented as weakened amygdala-vmPFC connectivity implicated in emotion-related attentional dysregulation. Conversely, negative stimuli might enhance temporally proximal visuoperceptual encoding after their disappearance. Contextual encoding bias could explain the overgeneralization (or lower coherence) of autobiographical memory and increase the risk of depression. The possible role of cortisol in recollecting the context of emotional events over time warrants further investigation.

Visual Attention and Cardiac Response to Faces in Relation to Emotion Recognition

Abstract: Rapid and accurate emotion recognition is a crucial skill for social interactions, and visual attention to informative social cues in the environment can facilitate emotion recognition. Studies have found that emotion recognition is also associated with underlying cardiac autonomic responses. The current study examined (1) visual attention and cardiac response (change in heart rate) to emotionally-expressive faces and houses (as a nonsocial control image), and (2) associations between these responses and emotion recognition on the Reading the Mind in the Eyes Test (RMET) in college students. Results showed increased overall attention, but shorter first fixation durations, to faces as compared to houses. Across faces, attention was greater to eyes than mouth, but the magnitude of this difference was dependent on emotion. Analysis of cardiac responses revealed greater heart rate deceleration to happy and fearful faces as compared to neutral faces and houses. Better emotion recognition accuracy on the RMET was related to greater attention to faces, and eyes specifically, as well as greater heart rate deceleration to faces relative to houses. No relations between visual attention and cardiac response were found. The current work points to variations in visual attention and cardiac responses while viewing emotional faces that can be markers of emotion processing ability.

Oxytocin moderates fMRI connectivity and response to implicit threat processing in cocaine use disorder

Stressful social experiences play an important role in increasing vulnerability to substance use, including cocaine. Oxytocin (OXT), known for its anxiolytic properties and involvement in social functioning, has been suggested as a potential therapeutic for cocaine use disorder (CUD). However, limited research has explored OXT’s influence on social stress in CUD, and no study has examined its effects on neural response to subconscious (implicit) social threat cues in this population. To address this gap, the present study administered intranasal OXT (24 IU) or placebo (PBO) to participants with CUD (CUD+, N = 76) or without CUD (CUD-, N = 61) in a randomized parallel design. Participants then completed a functional magnetic resonance imaging (fMRI) task involving briefly presented facial fear and anger (i.e., threat) cues, followed by neutral face stimuli. Whole-brain activation and amygdala functional connectivity (using psychophysiological interaction modeling) were examined in response to the facial threat cues. OXT reduced activation in the thalamus and pontine reticular formation in response to fear cues, and in the supplementary motor area for both fear and anger cues, regardless of CUD status. Additionally, under PBO, amygdala-medial prefrontal cortex connectivity to fear stimuli was negative for the CUD+ group, but under OXT, this coupling was positive, similar to the positive coupling observed for the CUD- group under both PBO and OXT administration. The finding of OXT-mediated reversal of amygdala-prefrontal coupling was specific to CUD+ and suggests that OXT alters circuitry related to threat surveillance and implicit emotion regulation in CUD. However, additional research is needed to determine whether these alterations due to OXT have clinical significance in CUD.

Perceptual sensitivity to labeling stereotyped emotion expressions: Associations with age and subclinical psychopathology symptoms from childhood through early adulthood.

This study investigates (a) age-related differences in how the intensity of stereotyped facial expressions influence the emotion label children, adolescents, and adults assign to that face and (b) how this perceptual sensitivity relates to subclinical symptoms of psychopathology. In 2015-2016, 184 participants aged 4-25 years viewed posed stereotypes of angry, fearful, sad, and happy expressions morphed with neutral expressions at 10%-90% intensity. Thin plate regression smoothing splines were used to chart nonlinear associations between age and the perceptual threshold participants needed to assign the emotion label expected based on cultural consensus. Results suggest that sensitivity to labeling stereotypical happy faces as "happy" peaked by age 4. Sensitivity to perceiving stereotypical angry faces as "angry" increased from ages 4 to 7 and then plateaued. In contrast, sensitivity to perceiving stereotypical fearful and sad faces demonstrated protracted development, not reaching a plateau until ages 15 and 16, respectively. Reduction in selecting the "I don't know" response was the primary driver of these age-related changes. Stereotyped fear expressions required the highest intensity to be labeled as such and showed the most marked change in perceptual threshold across development. Interestingly, lower intensity morphs of stereotypical fear faces were frequently labeled "sad." Furthermore, perceiving lower intensity fear morphs was associated with fewer internalizing and externalizing symptoms in participants aged 7-19. This study describes the development of perceptual sensitivity to labeling stereotypical expressions of emotion according to cultural consensus and shows that how people perceive and categorize ambiguous facial expressions is associated with vulnerability to psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PLAYING IN EARLY CHILDHOOD EDUCATION

Play is an essential form of communication and learning for children, allowing them to reproduce their daily lives, develop reflection, autonomy and creativity. Through play, children face fears and insecurities, interact socially and build knowledge in a playful way. This study highlights the importance of playing in child development, showing that playful activities are fundamental to both mental and body development. In addition, play helps in socialization, respect for rules and development of imagination. Early childhood education should incorporate the playful as an integral part of the teaching process, promoting significant and pleasurable learning.

Longitudinal changes in neural responses to fearful faces in adolescents with anorexia nervosa – A fMRI study

ObjectiveAlthough proven neuronal changes are correlated with anorexia nervosa (AN), where these changes occur and how they change during the course of this disease are often unclear; this is especially true regarding emotion processing, e.g., of anxiety, despite a growing body of literature on its importance for the pathophysiology and clinical course of patients with AN. MethodsTwenty-two female adolescent patients with AN were scanned during acute starvation and after short-term weight recovery and were compared to 27 healthy controls. A well-established face-matching paradigm involving individuals with different emotions was used during fMRI. ResultsPatients with AN selectively showed significantly increasing neural activation in the somatomotor cortex when viewing fearful faces following short-term weight recovery. No differences were found compared to healthy controls or for neutral, angry or surprised faces. Neural activation in response to fearful faces during acute starvation was associated with lower BMI-SDS and greater illness burden. ConclusionHigher somatomotor activity could represent anxiety-induced preparations for motor reactions (e.g., fight or flight) that are more pronounced in more affected patients. These results align with recent models of AN that increasingly incorporate anxiety into the pathophysiological and prognostic model of AN and help elucidate its underlying neurological mechanisms.

Creative puppet therapy reduces hallucinations in patients diagnosed with schizophrenia: Preliminary findings

Anomalous experiences and hallucinations characterize schizophrenia. This study aimed at determining the efficacy of creative puppet therapy (CPT; creation of a puppet with malleable DAS) to reduce severe anomalous experiences and hallucinations among patients diagnosed with schizophrenia. Double-blinded, controlled trials were performed on a convenience sample of 24 patients from a mental health center. The intervention group of 12 patients (who created puppets) and the pseudo-treatment group of 12 patients (who were involved in outdoor leisure trips) were compared to the control group of 12 control participants (who created puppets). Cardiff Anomalous Perceptions Scale (CAPS) assessed hallucinations; Emotional Expression Inventory (EEXI) assessed the emotional expression of one's own puppet. Puppet facial features were measured. Results showed that CPT effectively reduced (d = –4.00) hallucination frequency in patients. Hallucination reduction occurred across all sensory modalities, but touch and bodily interoception. Exteroceptive vs. interoceptive hallucinations was the most valuable classification in patients. Compared to controls, puppets created by patients expressed more negative emotions and had larger eye diameters, shorter noses, and larger whole face width. Eye diameter was correlated with fear, sadness, anger, and disgust, and whole face width with boredom. Fragmented-self integration of schizophrenia through CPT treatment might exploit aggregative dominance of the patient's own body.

Modulatory effects of goal relevance on emotional attention reveal that fear has a distinct value

ABSTRACT Threat-related stimuli can capture attention. However, it remains debated whether this capture is automatic or not. To address this question, we compared attentional biases to emotional faces using a dot-probe task (DPT) where emotion was never goal-relevant (Experiment 1) or made directly task-relevant by means of induction trials (Experiments 2–3). Moreover, the contingency between the DPT and induction trials was either partial (Experiment 2) or full (Experiment 3). Eye-tracking was used to ascertain that the emotional cue and the subsequent target were processed with peripheral vision. Experiments 1 and 2 both showed that negative faces captured attention, with faster target processing when it appeared on the same side as the preceding fearful face (i.e. fear-valid trials) compared to the opposite side where the neutral face was shown (i.e. fear-invalid trials), but also when it appeared on the side of the preceding neutral face (i.e. happy-invalid trials) compared to the happy face (i.e. happy-valid trials). Importantly, this preferential spatial orienting to negative emotion was not observed in Experiment 3, where the goal relevance of emotion was high. However, in that experiment, fearful faces produced a specific attentional bias during the DPT, which was mostly driven by the induction trials themselves.

Examining Brain Activity Responses during Rat Ultrasonic Vocalization Playback: Insights from a Novel fMRI Translational Paradigm.

Despite decades of preclinical investigation, there remains limited understanding of the etiology and biological underpinnings of anxiety disorders. Sensitivity to potential threat is characteristic of anxiety-like behavior in humans and rodents, but traditional rodent behavioral tasks aimed to assess threat responsiveness lack translational value, especially with regard to emotionally valenced stimuli. Therefore, development of novel preclinical approaches to serve as analogues to patient assessments is needed. In humans, the fearful face task is widely used to test responsiveness to socially communicated threat signals. In rats, ultrasonic vocalizations (USVs) are analogous social cues associated with positive or negative affective states that can elicit behavioral changes in the receiver. It is therefore likely that when rats hear aversive alarm call USVs (22 kHz), they evoke translatable changes in brain activity comparable with the fearful face task. We used functional magnetic resonance imaging in male and female rats to assess changes in BOLD activity induced by exposure to aversive 22 kHz alarm calls emitted in response to threatening stimuli, prosocial (55 kHz) USVs emitted in response to appetitive stimuli, or a computer-generated 22 kHz tone. Results show patterns of regional activation that are specific to each USV stimulus. Notably, limbic regions clinically relevant to psychiatric disorders (e.g., amygdala, bed nucleus of the stria terminalis) are preferentially activated by either aversive 22 kHz or appetitive 55 kHz USVs. These results support the use of USV playback as a promising translational tool to investigate affective processing under conditions of distal threat in preclinical rat models.

The eyes move towards fearful faces hundreds of milliseconds before they reach awareness

The eyes move towards fearful faces hundreds of milliseconds before they reach awareness

Incubating innovation: the role of incubators in supporting business model innovation

Purpose The role of incubators in promoting startup growth has received close research attention, but the findings paint a conflicting picture. This study aims to reduce the ambiguity surrounding incubator impact by exploring how incubators can support startups with business model innovations – a significant growth factor for startups neglected in the incubation literature. Design/methodology/approach Using a multiple-case study design, the authors conducted semistructured interviews with incubator directors and startup founders, offering insights into their experiences. The transcripts were coded following the Gioia method. Findings This study shows that incubatees are exposed to and struggle with business model innovation. Therefore, this study explores how incubators can support startups in innovating their business models. Research limitations/implications This research reveals the importance of addressing the psychological needs of entrepreneurs in incubators. By offering emotional support, incubators can create a positive psychological environment, helping entrepreneurs face fears and challenges. This highlights the human side of entrepreneurship, which has not been considered in the incubation literature. Practical implications Incubator directors can strengthen their programmes’ impact by offering tailored support for business model innovation and facilitating network connections. Policymakers should encourage ecosystem collaboration and allocate resources to effective programmes. Originality/value This research fills a gap in the incubation literature by emphasizing the significance and need for support for business model innovation. This study also offers original insights into the psychological dimensions of entrepreneurship.