The detrimental effects of atypical nonverbal behavior on older adults’ first impressions of individuals with Parkinson’s disease.

Abstract

After viewing short video clips of individuals with Parkinson's disease (PD) who varied in the symptoms of facial masking (reduced expressivity) and abnormal bodily movement (ABM: including tremor and related movement disorders), older adult observers provided their first impressions of targets' social positivity. Impressions of targets with higher masking or ABM were more negative than impressions of targets with lower masking or ABM. Furthermore, masking was more detrimental for impressions of women and when observers considered emotional relationship goals, whereas ABM was more detrimental for instrumental relationship goals. This study demonstrated the stigmatizing effects of both reduced and excessive movement.Keywords social perception; facial masking; tremor; Parkinson's disease; stigma Most research addressing how nonverbal behavior contributes to first impressions has been conducted with young, healthy students (Feldman & Tyler, 2006). This work demonstrates that many communication channels contribute to first impressions (Patterson & Manusov, 2006), and that more expressivity in these channels typically leads to more positive impressions (Bar, Neta, & Linz, 2006;Riggio & Friedman, 1986;Shrout & Fiske, 1981). However, less research has considered how aging may affect first impressions based on nonverbal behavior. Chronic conditions associated with aging can lead to atypical nonverbal expressivity by creating a dearth or excess of movement, such as reduced smiling and blinking; tremor; or uncoordinated, or uncontrollable movements. Atypical expressivity could compromise social relationships by reducing positive first impressions. This study focused on Parkinson's disease (PD), one of the most common chronic neurodegenerative disorders (Willis, Evanoff, Lian, Criswell, & Racette, 2010 With increasing facial masking in PD, facial movement becomes slower and more effortful, and expressions of emotion and social engagement become less spontaneous (Simons, Pasqualini, Reddy, & Wood, 2004;Smith, Smith, & Ellgring, 1996;Spielman, Borod, & Ramig, 2003). Higher facial masking has been perceived more negatively than typical expressivity (Pentland, 1991;Pentland et al., 1987;Pentland et al., 1988;Tickle-Degnen, Zebrowitz, & Ma, 2011), but only one study to date has investigated how age peers perceive masking (Hemmesch, Tickle-Degnen, & Zebrowitz, 2009).This study is among the first to examine how ABM, including tremor and jerky uncoordinated bodily movements, affects first impressions. ABM can jeopardize nonverbal communication (Pentland, 1991;Pitcairn et al., 1990) and may be associated with impressions of physical disability, although this hypothesis has not yet been tested.Facial masking has been found to be more detrimental to impressions of the social supportiveness of women with PD than men (Hemmesch et al., 2009;Tickle-Degnen et al., 2011). ABM may be more harmful for observers' impressions of men with PD than women because physical ability is more closely associated with male gender stereotypes (Woo...

Stigma as a key determinant of health-related quality of life in Parkinson’s disease

“…Quantitative research also has validated the source of stigma by surveying public attitudes toward PD [9] and by examining others’ impressions of PD symptoms [10-12]. Moore and Knowles reported that nearly half of survey respondents considered the disease to be stigmatizing [9].…”

“…In addition, Tickle-Degnen et al showed that facial masking may bias health care practitioners’ views of people with PD as more depressed, less sociable, and less cognitively competent than their actual attributes [10]. Moreover, Hemmesch et al reported that higher facial masking or higher abnormal bodily movement (including tremor and related abnormal movement) of individuals with PD elicited more negative first impressions in older adult observers [11, 12]. Due to both personal beliefs and public negative attitudes embedded in our society, people with PD are likely to feel stigmatized and thus suffer from psychological distress.…”

The Relationship between the Experience of Hypomimia and Social Wellbeing in People with Parkinson’s Disease and their Care Partners

“…Caregiving for a person with PD can lead to increased stress, depression, and decreased health in CPs [9–11], and these effects could be compounded if the person one is caring for is less able to communicate positive emotions like gratitude and happiness [12]. Understanding how CPs’ social lives are associated with their perceptions of their partners’ facial expression could give rise to potential ways to improve quality of life and relationships in care partners and people with PD.…”

Long-term Parkinson’s disease quality of life after staged DBS: STN vs GPi and first vs second lead

“…More LEDD use was associated with improvements in mobility and ADL subscores, which likely capture levodopa-responsive motor symptoms. Given the debilitating effects of tremor particularly on both ADLs and on stigma 27,28 , it was unsurprising that higher baseline tremor scores were associated with postoperative improvements for these subscores. A more unexpected result after unilateral DBS was that higher baseline PIGD scores were associated with less postoperative ADL improvement in the STN cohort, but more improvement in the GPi cohort.…”