Unmoving and unmoved: experiences and consequences of impaired non-verbal expressivity in Parkinson’s patients and their spouses

Abstract

The results indicate masking can have an adverse impact on close relationships and psychological well-being. This study presents an initial basis for clinicians working with Parkinson's populations to recognize of the needs of people who experience masking and better support such individuals and their families to live satisfying social and emotional lives. Implications for Rehabilitation People who have Parkinson's and their families are often unaware facial masking is a symptom of Parkinson's disease. Masking may be confused with negative affect and become a barrier to satisfying close relationships. Masking related health resources and support are perceived to be of poor availability and quality. This qualitative study suggests masking be considered as an etiology of interpersonal and psychological difficulties in Parkinson's disease, and encourages better recognition of this unique population's health education needs.

Social Symptoms of Parkinson’s Disease

“…Furthermore, education for patients and their caregivers about socioemotional symptoms and associated consequences can help prepare patients for these potential issues (Wootton et al, 2019). Moreover, encouraging patients to have an active role in educating their family and friends about their disease can be helpful in reducing social isolation (M. Y.…”

“…Indeed, one study found that patients with greater facial masking have reported experiencing greater self-reported social exclusion (Gunnery et al, 2016). In another study, over half of PD participants blamed masking specifically for their feelings of social distance between themselves and their partners (Wootton et al, 2019). Dysarthria can contribute to social withdrawal as well.…”

“…Some PD patients have employed informal strategies to compensate for socioemotional symptoms like facial masking and dysarthria. For example, patients might turn to other channels of communication (e.g., physical touch, email, note-writing) to more clearly express their emotions (Miller et al, 2006;Wootton et al, 2019). More formal strategies include exercises designed to preserve or amplify patients' communication abilities (Wootton et al, 2019).…”

“…For example, patients might turn to other channels of communication (e.g., physical touch, email, note-writing) to more clearly express their emotions (Miller et al, 2006;Wootton et al, 2019). More formal strategies include exercises designed to preserve or amplify patients' communication abilities (Wootton et al, 2019). For example, the Lee Silverman Voice Treatment (LSVT LOUD;Ramig et al, 1995) combines vocal and respiratory exercises designed to increase vocal loudness.…”

“…Importantly, it is currently unclear how dopaminergic medication affects social symptoms like facial masking, dysarthria, and the perception of verbal and non-verbal emotional expression. Despite the lack of evidence in this area, some patients report selfadministering extra tablets of dopaminergic medication to help alleviate social symptoms such as facial masking (Wootton et al, 2019). However, this could cause further problems (e.g., dyskinesias) in the long run (Pandey & Srivanitchapoom, 2017).…”