Bringing mental health to the frontlines: A proactive team-based model for healthcare workers during the COVID-19 pandemic.

OBJECTIVE: A novel team-based service was developed at the beginning of the pandemic in which sixty liaisons were assigned to provide proactive, tailored psychological support for healthcare workers (HCWs) across three of NewYork-Presbyterian's Weill Cornell affiliated hospitals. METHOD: The program took the proactive approach of bringing mental health awareness to every department and major division that interfaced with COVID-19 patients. Virtual and in-person team-based "town hall" meetings were offered to provide psychoeducation, facilitate discussion, foster adaptive coping and social cohesion, and identify employees who would benefit from further individualized support. RESULTS: The program's success was reflected in the number of town halls (1000+) and attendees (6000+) and in qualitative feedback from departments who requested ongoing services. CONCLUSIONS: This article presents the development, implementation, challenges, and opportunities in designing a team-based support model for HCWs. This model may be useful for organizations that seek to develop similar programs.

The development of template-based facial expression perception from 6 to 15 years of age.

When perceiving emotional facial expressions, adults use a template-matching strategy, comparing the perceived face with a stored representation. A rejection of unnaturally exaggerated faces is characteristic of this strategy because the exaggerated expressions do not match the stored template. In contrast, a rule-based perceptual strategy (e.g., wide eyes indicate surprise) would be more tolerant of exaggeration. The current study uses exaggeration tolerance to test the expression perception strategies of children from 6 to 15 years of age. In Experiment 1, 62 (38 male) participants viewed pairs of happy or sad faces varying in exaggeration and selected the face that looked closest to how a happy (or sad) person really looks. With age, children became less likely to choose the more exaggerated expression. In Experiment 2, this result was replicated with each of the six basic emotions. Sixty-six children (26 male, 50 Caucasian, 10 mixed-race, four Indian, two unidentified) from 6 to 15 years of age completed the same experimental tasks as Experiment 1 for all six emotions. Again, with age children became less likely to choose the more exaggerated face. The results from both experiments suggest that the development of an adult-like template-matching strategy lasts into adolescence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Disambiguating auditory information causes priming, but not aftereffects, in the perception of ambiguous faces.

In five experiments, we used a visual aftereffects paradigm to probe whether emotion- and gender-relevant information presented in the auditory domain would affect the formation of visual aftereffects or would instead create a priming effect. In experiment 1, participants fixated on surprise facial expressions while listening to a story that described the surprise as either happy or sad, and then were asked to classify the expression of a briefly presented neutral face. Subsequently, the identity of the model (experiment 2) and the timing of the auditory presentation (experiment 3) were manipulated. In experiment 4, this approach was extended to judgments of gender. Experiment 5 serves as a control experiment in which the story, but no visual stimuli, was presented during the adaptation phase. In each case results revealed evidence of priming, but no evidence that information in the auditory domain affected the formation of aftereffects.

Processing Speed is Impaired in Adults with Autism Spectrum Disorder, and Relates to Social Communication Abilities.

Autism spectrum disorder (ASD) is characterized by a variety of social and non-social behavioral deficits. One potential mechanism that could unify this diverse profile of behaviors is slower processing speed. Seventy-six high-functioning adults with ASD were compared to 64 matched controls on standardized measures of processing speed. Participants with ASD were significantly slower on all measures, and on the composite score from the three tests (d's > .65). ASD participants with slower processing speeds scored higher on the ADOS Communication and Reciprocal Social Interaction scale (r = .34). These findings provide evidence of slower processing speeds in adults with ASD, and that this may be contributing to impairments in social communication skills. Interventions that improve processing speed might improve social communication abilities in ASD.

Emotion Perception or Social Cognitive Complexity: What Drives Face Processing Deficits in Autism Spectrum Disorder?

Some, but not all, relevant studies have revealed face processing deficits among those with autism spectrum disorder (ASD). In particular, deficits are revealed in face processing tasks that involve emotion perception. The current study examined whether either deficits in processing emotional expression or deficits in processing social cognitive complexity drive face processing deficits in ASD. We tested adults with and without ASD on a battery of face processing tasks that varied with respect to emotional expression processing and social cognitive complexity. Results revealed significant group differences on tasks involving emotional expression processing, but typical performance on a non-emotional but socially complex task. These results support an emotion processing rather than a social complexity explanation for face processing deficits in ASD.

Adults with autism spectrum disorder show evidence of figural aftereffects with male and female faces.

The norm-based coding model of face perception posits that face perception involves an implicit comparison of observed faces to a representation of an average face (prototype) that is shaped by experience. Using some methods, observers with autism spectrum disorder (ASD) have shown atypical face perception, but other methods suggest preserved face perception. Here, we used a figural aftereffects paradigm to test whether adults with ASD showed evidence of norm-based coding of faces, and whether they encode separate prototypes for male and female faces, as typical observers do. Following prolonged exposure to distorted faces that differ from their stored prototype, neurotypical adults show aftereffects: their prototype shifts in the direction of the adapting face. We measured aftereffects following adaptation to one distorted gender. There were no significant group differences in the size or direction of the aftereffects; both groups showed sex-selective aftereffects after adapting to expanded female faces but showed aftereffects for both sexes after adapting to contracted face of either sex, demonstrating that adults with and without ASD show evidence of partially dissociable male and female face prototypes. This is the first study to examine sex-selective prototypes using figural aftereffects in adults with ASD and replicates the findings of previous studies examining aftereffects in adults with ASD. The results contrast with studies reporting diminished adaptation in children with ASD.

Brief Report: Infants Developing with ASD Show a Unique Developmental Pattern of Facial Feature Scanning.

Infants are interested in eyes, but look preferentially at mouths toward the end of the first year, when word learning begins. Language delays are characteristic of children developing with autism spectrum disorder (ASD). We measured how infants at risk for ASD, control infants, and infants who later reached ASD criterion scanned facial features. Development differed across groups. The preference for the eyes region decreased with age in infants who were at risk of ASD. For the control group the change in feature preference was marginally significant for a quadratic model, reflecting a decrease in the preference for eyes at 9 months followed by a recovery. The infants who later reached ASD criterion did not show a significant change across time.

Norm-based coding of facial identity in adults with autism spectrum disorder.

It is unclear whether reported deficits in face processing in individuals with autism spectrum disorders (ASD) can be explained by deficits in perceptual face coding mechanisms. In the current study, we examined whether adults with ASD showed evidence of norm-based opponent coding of facial identity, a perceptual process underlying the recognition of facial identity in typical adults. We began with an original face and an averaged face and then created an anti-face that differed from the averaged face in the opposite direction from the original face by a small amount (near adaptor) or a large amount (far adaptor). To test for norm-based coding, we adapted participants on different trials to the near versus far adaptor, then asked them to judge the identity of the averaged face. We varied the size of the test and adapting faces in order to reduce any contribution of low-level adaptation. Consistent with the predictions of norm-based coding, high functioning adults with ASD (n = 27) and matched typical participants (n = 28) showed identity aftereffects that were larger for the far than near adaptor. Unlike results with children with ASD, the strength of the aftereffects were similar in the two groups. This is the first study to demonstrate norm-based coding of facial identity in adults with ASD.

Afterimage induced neural activity during emotional face perception.

The N170 response differs when positive versus negative facial expressions are viewed. This neural response could be associated with the perception of emotions, or some feature of the stimulus. We used an aftereffect paradigm to clarify. Consistent with previous reports of emotional aftereffects, a neutral face was more likely to be described as happy following a sad face adaptation, and more likely to be described as sad following a happy face adaptation. In addition, similar to previous observations with actual emotional faces, we found differences in the latency of the N170 elicited by the neutral face following sad versus happy face adaptation, demonstrating that the emotion-specific effect on the N170 emerges even when emotion expressions are perceptually different but physically identical. The re-entry of emotional information from other brain regions may be driving the emotional aftereffects and the N170 latency differences.

Strategies for perceiving facial expressions in adults with autism spectrum disorder.

Rutherford and McIntosh (J Autism Dev Disord 37:187­196, 2007) demonstrated that individuals with autism spectrum disorder (ASD) are more tolerant than controls of exaggerated schematic facial expressions, suggesting that they may use an alternative strategy when processing emotional expressions. The current study was designed to test this finding using photographs of real people. In addition, two control tasks were added to eliminate alternative explanations. We replicated the findings of Rutherford and McIntosh (J Autism Dev Disord 37:187­196, 2007) and also demonstrated that adults with ASD do not show this tolerance when evaluating how realistic the expressions are. These results suggest adults with ASD employ a rule-based strategy to a greater extent than typical adults when processing facial expressions but not when processing other aspects of faces.

The influences of face inversion and facial expression on sensitivity to eye contact in high-functioning adults with autism spectrum disorders.

We examined the influences of face inversion and facial expression on sensitivity to eye contact in high-functioning adults with and without an autism spectrum disorder (ASD). Participants judged the direction of gaze of angry, fearful, and neutral faces. In the typical group only, the range of directions of gaze leading to the perception of eye contact (the cone of gaze) was narrower for upright than inverted faces. In both groups, the cone of gaze was wider for angry faces than for fearful or neutral faces. These results suggest that in high-functioning adults with ASD, the perception of eye contact is not tuned to be finer for upright than inverted faces, but that information is nevertheless integrated across expression and gaze direction.