Smiling Response Research Articles

Smile and laughter induction and intraoperative predictors of response to deep brain stimulation for obsessive-compulsive disorder

We recently treated six patients for OCD utilizing deep brain stimulation (DBS) of the anterior limb of the internal capsule and the nucleus accumbens region (ALIC-NA). We individually tested leads via a scripted intraoperative protocol designed to determine DBS-induced side effects and mood changes. We previously published qualitative data regarding our observations of induced emotional behaviors in our first five subjects. We have now studied these same behaviors in the full cohort of six patients over 2 years of follow-up and have examined the relationship of these behaviors to intraoperative mood changes and postoperative clinical outcomes. Five patients experienced at least one smile response during testing. At higher voltages of stimulation, some of these smiles progressed to natural laughter. Smiles and laughter were associated with mood elevation. At stimulation locations at which smiles were observed, voltage and mood were significantly correlated ( p = 0.0004 for right brain and p < 0.0001 for left brain). In contrast, at contacts where smiles were not observed, mood was negatively correlated with voltage ( p = 0.0591 for right brain and p = 0.0086 for left). Smile and laughter-inducing sites were located relatively medial, posterior, and deep in the ALIC-NA. The presence of stimulation induced laughter predicted improvement in OCD symptoms at 2 years. The higher the percentage of laugh conditions experienced in an individual patient, the greater the reduction in YBOCS (24 months, p = 0.034). Other correlations between clinical outcomes and percent of smile/laugh conditions were not significant. These stimulation-induced behaviors were less frequently observed with 1 and 2-month postoperative test stimulation and were not observed at subsequent test stimulation sessions. Intraoperative stimulation-induced laughter may predict long-term OCD response to DBS. Identifying other potential response predictors for OCD will become increasingly important as more patients are implanted with DBS devices. A larger study is needed to better delineate the relationship between induced intraoperative and postoperative emotional behavior and clinical outcome in patients treated with DBS therapy.

Preservation of differences in social versus non-social positive affect in children exposed to war

No research to date has supported the ‘social contagion’ effect of laughter and smiles in a non-Western context, nor among children. Expressions of positive affect were here compared according to social and non-social conditions among 163 children between the ages of 5–12 while playing in a park in Afghanistan. Independent observers coded laugh and smile responses using published criteria and identified 147 laugh responses and 697 smile responses. Children in the social play condition demonstrated significantly more laughs than children in the non-social play condition, and the number of peer observers present in the social play condition significantly increased the number of participant smile responses, but not laugh responses. Findings supported the idea in Western research that laughter and smiles may function in moderating social relationships and communicating affect. The authors recommend future research to investigate the relationship between positive affect and well-being across cultures, with consideration for practical interventions.

Long-term Habituation of the Smile Response with Deep Brain Stimulation

Human and animal research has shown that the ventral striatum, including the nucleus accumbens, may play a critical role in mediating positive emotions. Recently we described a subject with obsessive-compulsive disorder who intra-operatively exhibited the acute onset of an asymmetric smile and acute positive emotional change with contralateral deep brain stimulation (DBS) in either the right or left nucleus accumbens and anterior limb of the internal capsule region. The purpose of the present study was to examine the stability of the stimulation-induced smile(s) over a 12-month period. Custom computer software objectively quantified left and right facial movement during DBS. Although stimulation-induced smiles were elicited at one and two months post-surgery, they were no longer present from 3–12 months following chronic high frequency DBS. The smiles could not be elicited even with long washout periods. These findings imply potential long-term habituation and changes in the neural chemistry (possibly neuroplasticity) induced by chronic DBS. This study was supported by grants from NIMH (R01MH62539, PI:Bowers; R21MH064161, PI:Goodman) and NINDS (R01N550633, PI: Bowers). We would also like to acknowledge the DBS for OCD Study Group and the University of Florida Movement Disorders Center.

Aloneness with aesthetic pleasure: a developmental step reflected in memory and dream.

On occasion, adult patients report a dream in which they are very young, or they remember a dream from early childhood, or they report an early memory, all of which go something like this: I am very young, in my crib, or on a bed, or in my room. I am totally alone, but I don’t mind, I am not lonely, I feel quite safe. I am very peaceful. I am looking at something very beautiful, or I am aware that the room is very beautiful, or the room is suffused with a beautiful light, or I hear music which is very beautiful. Patients often comment of these experiences, whether memory or dream, that they have great aesthetic intensity, and they underscore the aloneness, and how comfortable the aloneness feels. We can think of these experiences, “aloneness with aesthetic pleasure,” as evidence of a profound emotional and developmental step, crucial to the separation-individuation process, involving a shift in object relatedness and libidinal cathexes, emerging some time following the sequence of experiences which Winnicott (1958) described as the capacity to be alone in the presence of the mother, and similar to the three organizers postulated by Spitz (1965). Spitz describes certain reorganizations of psychic structures during the first year of life, which herald evolving personality capabilities and increasing differentiation within the psychic structure. He identifies three significant and observable factors, which he calls organizers: (1) reciprocal smiling response (p. 117), (2) eight-month anxiety (stranger anxiety) (p. 160), and (3)

Working with People: How to Set Limits When a Patient Demands Too Much

What should you do when you feel angry with a patient or don't like him? Is it OK to let patients know how you feel? Most of us become uncomfortable when we experience strong negative feelings toward patients. We withdraw or try to avoid the person. While this response may work in short-term encounters, the nurse-patient relationship demands that we solve, not ignore, the problem. In working with sick people daily, it becomes easy to take for granted the profound impact illness has on people. Most patients feel very vulnerable and are frightened by their dependence on us. They perceive our distancing or avoidance as abandonment. They will do whatever it takes to counteract our behavior, to keep us involved. Thus, if we do not deal with our dislike of a patient, we set up a situation where a patient must yell to get our attention. Should we try to ignore our angry feelings and force ourselves to be pleasant? Again, this response isn't appropriate. First, difficult patients are, on some level, aware of how they are affecting others and don't trust an unrealistic smiling response. Instead, they may worry that you are

Infant Crying and Fussing

The study investigated infants' rates of fussing and crying in five environments in the following situations: An entire observation day in the child's natural surroundings, in the presence of familiar people, when alone, and when the main caretaker was requested to elicit a smiling response from the infant. Observed were 96 male infants aged 2, 4, 7, and 11 months from urban middle and lower class, kibbutz, Bedouin, and institutional environments in their natural surroundings for the equivalent of a complete waking day. Our findings indicated that prompt reaction to most infants' cries and fussing was associated with a higher rate of these responses in everyday life and during a pleasant encounter with the mother. Rates of infants' fussing were found to be higher when alone than in presence of familiar people.

Social concomitants of cognitive mastery in Down's syndrome infants

Smiling as an index of cognitive mastery was examined in a study of seven infants clinically diagnosed as having Down's syndrome. The subjects were administered the Uzgiris-Hunt scales of infant psychological development on five occasions over a four month period of time, and their smiling responses to their successful and unsuccessful completion of the items administered were coded. Two hypothesis derived from J. McVicker Hunt's theory of intrinsic motivation were tested: (a) sense of pleasure derived from successful solutions would be greater than to tasks not solved correctly, and (b) sense of pleasure to optimally challenging tasks would be greater than to tasks which could be solved easily. The findings provided support for the first but not the second prediction. The results are interpreted in terms of similarities and differences found in the present and previous investigations, and the implications of the findings are discussed.

Pre-literate people in New Guinea and Indonesia draw specifically distorted faces, as do 'Western' dyslexics, using a paleo visual-representational mode.

Third World populations with a persisting high percentage of preliterates within individual groups draw specifically distorted patterns of the human face characteristic of 'neolithic art' to a degree negatively correlated with the accessibility of reading instruction. A subgroup of 'Western' dyslexic youths also draw these distorted face patterns, which, moreover, facilitate infants 'smiling response'. These findings suggest the persistence of a developmentally early visual representational mode which proceeds in a global way, disregarding differences in characterizing details, whether of face patterns or of lexical symbols.

Developmental phases in visual recognition of the human face pattern, exemplified by the 'smiling response'.

Unter den visuellen Reizkonfigurationen, die das Kinderlacheln austosen, wurde eine neue Klasse von Fruhformen (NGr und NGl) experimentell identifiziert. Analoge Gesichtskonfigurationen sind in Fruhdarstellungen des Gesichts in «neolithischer» Kunst sowie auch in der spezifischen Weise des visuellen Erlebens des Gesichts in Prosopagnosie zu finden.

Sociocultural Factors and the Early Manifestation of Sociability Behavior Among Baranda Infants

Sociocultural Factors and the Early Manifestation of Sociability Behavior Among Baranda Infants

A note on weight discrepancy and humor.

Summary In a test of the discrepancy hypothesis of humor, Ss compared 11 comparison weights to a 90 gram standard. The 12th and 13th comparison weights were identical with, much lighter than, or heavier than the standard. More smile and laugh responses were made to the latter weights, and the number of these responses declined during the second presentation of those weights. The results supported the discrepancy hypothesis.

乳児の微笑反応についての縦断的研究

14 infants were measured in terms of their smiling, attention, reaching and crying responses to the stimuli of 4 auditory and 7 visual from the 1st to the 7th month, every month. All except one had already been recorded spontaneous smiling responses at age of 3 to 6 days. Voices, bugles and rattles which had relatively highpitched sounds elicited more frequent smiles than the low-sound bells. The correlation coefficients between the smiling time recorded on the 4th, 5th, 6th and 7th months were significantly high for the visual stimuli. The smiling time to each facial models was in proportion to the similarities to the actual adult faces after the 4th month. The correlation coefficients between the spontaneous smiling time immediately after birth and the elicited smiling time after 4th month were found to be significantly high. The elicited smiles of infants seem to be based on the innate spontaneous smiles.

Smiling in children as a function of their sense of mastery

The relationship between a child's tendency to smile and mastery behavior was examined by comparing the magnitude of the smiling response to correct and incorrect responses on a picture vocabulary test. Test items were preselected according to 4 levels of difficulty, ranging from easy to nearly impossible. Two age levels (4 and 8) were employed. The findings revealed a highly significant overall effect for item correctness indicating more smiling to correct than incorrect responses for children at both age levels. There was no evidence for a predicted positive relationship between item difficulty and smiling. The findings were interpreted as partially supporting those formulations which emphasize the gratification derived from a sense of mastery or competence.

Extinction of the Smiling Response in Infants as a Function of Reinforcement Schedule

Extinction of the Smiling Response in Infants as a Function of Reinforcement Schedule

EXTINCTION OF THE SMILING RESPONSE IN INFANTS AS A FUNCTION OF REINFORCEMENT SCHEDULE1

Scheduling of reinforcement has been investigated extensively in relation to the conditioning of non-social responses. The results of these studies indicate in general that a schedule by which reinforcement follows every response is less effective in maintaining performance of that response during extinction than is a schedule by which reinforcement follows only some of those responses (4). This investigation attempts to extend the study of frequency and patterning of reinforcement to the area of social learning and to cortically immature subjects. The purpose of the research is to evaluate the relative efficacy of intermittent as opposed to regular reinforcement upon frequency of smiling in infants. The use of an instrumental conditioning paradigm in this study is in contrast to past studies of the conditioning of the smiling response (2, 7, 8), all of which, though differing in methodology, have utilized a classical conditioning paradigm in conceptualizing results. The inappropriateness of this framework in accounting for response change over time is most clearly illustrated in the study by Dennis (2).

Development of Interpersonal Smiling Responses in the Preschool Years

Development of Interpersonal Smiling Responses in the Preschool Years

TEOC, where Negro field hands stay—where, too, they get all they earn and know they get it

Labor, they tell me, is scarce further over in the Yazoo Delta, remarked William Moore, the negro farmer-merchant whom I had found in his store on his place. here along Teoc Creek every planter has his cabins full. What makes this neighborhood different from others here in Mississippi? I inquired. That is a question I wouldn't undertake to answer, not knowing other communities as I know this, was the smiling response. I can tell you why labor likes to stay on Teoc, for that's easy. An honest man lived here years ago. By his own example of fair dealing with the 'hands' on his plantation he fixed the custom in this neighborhood of giving every man his just due. It's strange about him. He wasn't exactly a business success himself; and yet because of him other men have made money here ever since, for the laborer gets his due and knows it. So all along this creek there is never a lack of workers. Who was this man? John S. McCain. He lives out at Carrollton now with one of his children, but his principle of fair treatment is still the fixed rule of this community. His son has the father's plantation, and he is making good. He is just as fair as the old man in his dealings. But I would say he is more businesslike. He opened a store on his place a year or two ago, and now he's got all the business he wants. There was an old gentleman in the neighborhood who had a general store, and who was just as fair in his dealings; but, somehow, Mr. Joe McCain has had no trouble in getting trade. The talk went back to the father. He was, I recalled, the sheriff in my boyhood days-a man held in high respect by all the county. I heard people speak then of his integrity, but I was too young at that time to realize what a high adventure just being honest often proves to be. Now, it was a pleasant thing to hear this simple explanation of why