Profile of social self-management practices in daily life with Parkinson's disease is associated with symptom severity and health quality of life.

PURPOSE: Social participation is a key determinant of healthy aging, yet little is known about how people with Parkinson's disease manage social living. This study describes individual differences in social self-management practices and their association with symptom severity and health quality of life. METHODS: People with Parkinson's disease (N = 90) completed measures of healthy routines, activities and relationships, symptom severity, and health related quality of life. Cluster analysis identified profiles of social self-management practices. Analysis of variance tested differences between profiles in symptom severity and health quality of life. RESULTS: Participants clustered into one of seven groups according to different combinations of three practices: health resources utilization, activities in home and community, and social support relationships. The healthiest cluster engaged equally in all three practices at above sample average degree of engagement. Four clusters that engaged at or above sample average in activities in home and community experienced less health problems than three clusters that engaged below average. Variation in aspects of social lifestyle unrelated to health appeared also to contribute to profile diversity. CONCLUSION: Findings provide insight into similarity and variation in how people with Parkinson's disease engage with social self-management resources and point to person-centered interventions.Implications for RehabilitationSocial self-management is a biopsychosocial construct to identify and describe self-care practices that engage one's social resources for managing healthful daily living.People with Parkinson's disease vary in their profiles of engaging in social self-management practices in daily living, and this variability relates to severity of symptoms and health quality of life.Learning how to identify health-centered social self-management practices may help people with Parkinson's disease to focus on the healthfulness of their own practices.Learning how to strategically engage one's social resources as part of self-care may help people with Parkinson's disease to master managing their health and well-being in daily life.

Experienced facial masking indirectly compromises quality of life through stigmatization of women and men with Parkinson's disease.

This study examined the relationship between self-reported facial masking and quality of life (QoL) in people with Parkinson's disease (PD), and tested experienced stigma as a mediator and gender as a moderator of this relationship. The strength of stigma as a mediator was compared against an alternative mediator, depression. Ninety people with PD (34 women) rated difficulty showing facial expression (masking), and completed the Stigma Scale for Chronic Illness, Geriatric Depression Scale (15-item), and Parkinson's Disease Questionnaire-39. A conditional process model tested the indirect effect of facial masking on QoL through stigma, separately for women and men. A parallel indirect model included both stigma and depression to compare their statistical and clinical significance as mediators. Gender-moderated mediation of stigma reduced the association between facial masking and QoL to non-significance, suggesting stigma explained the association between facial masking and QoL. While facial masking was more stigmatizing for women than for men, stigma mediated the facial masking-QoL association for both women and men. Stigma (controlling for depression) reached a statistically and clinically significant level of mediation, whereas depression (controlling for stigma) reached a statistically yet not clinically significant level of mediation. People with PD who experience more severe facial masking feel more stigmatized, especially women. Regardless of gender, an increase in stigma from facial masking increases the likelihood of compromised QoL that reaches both statistical and clinical levels of significance.

Mapping spontaneous facial expression in people with Parkinson's disease: A multiple case study design.

People with Parkinson's disease (PD) often experience a decrease in their facial expressivity, but little is known about how the coordinated movements across regions of the face are impaired in PD. The face has neurologically independent regions that coordinate to articulate distinct social meanings that others perceive as gestalt expressions, and so understanding how different regions of the face are affected is important. Using the Facial Action Coding System, this study comprehensively measured spontaneous facial expression across 600 frames for a multiple case study of people with PD who were rated as having varying degrees of facial expression deficits, and created correlation matrices for frequency and intensity of produced muscle activations across different areas of the face. Data visualization techniques were used to create temporal and correlational mappings of muscle action in the face at different degrees of facial expressivity. Results showed that as severity of facial expression deficit increased, there was a decrease in number, duration, intensity, and coactivation of facial muscle action. This understanding of how regions of the parkinsonian face move independently and in conjunction with other regions will provide a new focus for future research aiming to model how facial expression in PD relates to disease progression, stigma, and quality of life.

Accuracy of Judging Affect and Accuracy of Judging Personality: How and When Are They Related?

OBJECTIVES: The present research is concerned with the relation between accuracy in judging targets' affective states and accuracy in judging the same targets' personality traits. In two studies, we test the link between these two types of accuracy with the prediction that accuracy of judging traits and of judging states will be associated when fundamental affective qualities are shared. METHOD: In Study 1, affective states and personality traits of 29 targets were rated by 124 judges whose individual accuracy was scored as the correlation between their ratings and target criterion scores (across targets). In Study 2, a comparable analysis was done using 30 different targets and 330 different judges. RESULTS: Accuracy in judging distressed affect was significantly positively correlated with accuracy in judging Neuroticism in both studies, as well as in a meta-analysis across the two studies. Accuracy in judging positive affect was significantly positively correlated with accuracy in judging Extraversion in one of the two studies, with the meta-analysis across the two studies being significant. CONCLUSIONS: These findings provide preliminary evidence for a new model (State and Trait Accuracy Model) that outlines when concordance in accuracy across traits and states should be expected.

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

BACKGROUND: Though hypomimia, also called facial masking, is experienced by many people with Parkinson's disease (PD), little is known about how the experience of this motor impairment relates to their own and their care partners' (CP) social life and relationship quality. OBJECTIVE: To test if the experience of facial masking relates to social wellbeing in people with PD and their CPs. METHOD: Forty individuals with PD and their CPs rated PD's difficulty showing facial expression (facial masking), and completed questionnaires about their own social wellbeing and depression. RESULTS: PD-reported and CP-reported facial masking of PD were positively correlated with experience of social rejection in both partners, though this relationship was diminished when controlling for depression. CPs' rating of their partner's facial masking was negatively associated with enjoyment interacting with their partner. This relationship remained when controlling for CP and PD depression. CONCLUSIONS: The findings suggest that the experience of facial masking is negatively associated with social wellbeing particularly for the CPs, and especially so for the quality of CPs interpersonal relationship with their partner with PD.

Perceptions of Duchenne and non-Duchenne smiles: A meta-analysis.

A meta-analysis was conducted to compare perceptions of Duchenne smiles, smiles that include activation of the cheek raiser muscle that creates crow's feet around the eyes, with perceptions of non-Duchenne smiles, smiles without cheek raiser activation. In addition to testing the overall effect, moderator analyses were conducted to test how methodological, stimulus-specific and perceiver-specific differences between studies predicted the overall effect size. The meta-analysis found that, overall, Duchenne smiles and people producing Duchenne smiles are rated more positively (i.e., authentic, genuine, real, attractive, trustworthy) than non-Duchenne smiles and people producing non-Duchenne smiles. The difference between Duchenne and non-Duchenne smiles was greater when the stimuli were videos rather than photographs, when smiles were elicited naturally rather than through posing paradigms and when Duchenne and non-Duchenne smiles were not matched for intensity of the lip corner puller in addition to other perceiver and methodological moderators.