Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-24T20:09:17.016Z Has data issue: false hasContentIssue false

Emotional Regulation Impairments Following Severe Traumatic Brain Injury: An Investigation of the Body and Facial Feedback Effects

Published online by Cambridge University Press:  28 January 2013

Marie Dethier*
Affiliation:
Department of Psychology: Cognition and Behavior, University of Liège, Liège, Belgium
Sylvie Blairy
Affiliation:
Department of Psychology: Cognition and Behavior, University of Liège, Liège, Belgium
Hannah Rosenberg
Affiliation:
School of Psychology, University of New South Wales, Sydney, NSW, Australia
Skye McDonald
Affiliation:
School of Psychology, University of New South Wales, Sydney, NSW, Australia
*
Correspondence and reprint requests to: Marie Dethier, University of Liège, Department of Psychology: Cognition and Behavior, Unit of Cognitive and Behavioural Clinical Psychology, Boulevard du Rectorat, 3, (B33) 4000 Liège. Belgium. E-mail: [email protected]

Abstract

The object of this study was to evaluate the combined effect of body and facial feedback in adults who had suffered from a severe traumatic brain injury (TBI) to gain some understanding of their difficulties in the regulation of negative emotions. Twenty-four participants with TBI and 28 control participants adopted facial expressions and body postures according to specific instructions and maintained these positions for 10 s. Expressions and postures entailed anger, sadness, and happiness as well as a neutral (baseline) condition. After each expression/posture manipulation, participants evaluated their subjective emotional state (including cheerfulness, sadness, and irritation). TBI participants were globally less responsive to the effects of body and facial feedback than control participants, F(1,50) = 5.89, p = .02, η2 = .11. More interestingly, the TBI group differed from the Control group across emotions, F(8,400) = 2.51, p = .01, η2 = .05. Specifically, participants with TBI were responsive to happy but not to negative expression/posture manipulations whereas control participants were responsive to happy, angry, and sad expression/posture manipulations. In conclusion, TBI appears to impair the ability to recognize both the physical configuration of a negative emotion and its associated subjective feeling. (JINS, 2013, 19, 1–13)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adolphs, R. (2002). Recognizing emotion from facial expressions: Psychological and neurological mechanisms. Behavioral and Cognitive Neuroscience Reviews, 1(1), 21–62. doi:http://dx.doi.org/10.1177/1534582302001001003CrossRefGoogle Scholar
Adolphs, R. (2003). Cognitive neuroscience of human social behaviour. Nature Reviews. Neuroscience, 4(3), 165–178. doi:http://dx.doi.org/10.1038/nrn1056CrossRefGoogle Scholar
Alderman, N. (2003). Contemporary approaches to the management of irritability and aggression following traumatic brain injury. Neuropsychological Rehabilitation, 13(1–2), 211240. doi:10.1080/09602010244000327.CrossRefGoogle Scholar
Allerdings, M.D., Alfano, D.P. (2001). Alexithymia and impaired affective behavior following traumatic brain injury. Brain and Cognition, 47(1–2), 304365. doi:10.1006/brcg.2000.1281Google Scholar
Andréasson, P., Dimberg, U. (2008). Emotional empathy and facial feedback. Journal of Nonverbal Behavior, 32(4), 215224. doi:10.1007/s10919-008-0052-zCrossRefGoogle Scholar
Angrilli, A., Palomba, D., Cantagallo, A., Maietti, A., Stegagno, L. (1999). Emotional impairment after right orbitofrontal lesion in a patient without cognitive deficits. Neuroreport, 10(8), 17411746.CrossRefGoogle Scholar
Baguley, I.J., Cooper, J., Felmingham, K. (2006). Aggressive behavior following traumatic brain injury: How common is common? The Journal of Head Trauma Rehabilitation, 21(1), 4556. doi:10.1097/00001199-200601000-00005CrossRefGoogle ScholarPubMed
Becerra, R., Amos, A., Jongenelis, S. (2002). Organic alexithymia: A study of acquired emotional blindness. Brain Injury, 16(7), 633645.CrossRefGoogle ScholarPubMed
Bem, D.J. (1967). Self-perception: An alternative interpretation of cognitive dissonance phenomena. Psychological Review, 74(3), 183200. doi:10.1037/h0024835CrossRefGoogle ScholarPubMed
Berthoz, S., Artiges, E., Van De Moortele, P.-F., Poline, J.-B., Rouquette, S., Consoli, S.M. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. American Journal of Psychiatry, 159(6), 961967.CrossRefGoogle ScholarPubMed
Blair, R.J., Cipolotti, L. (2000). Impaired social response reversal. A case of ‘acquired sociopathy’. Brain, 123(6), 11221141.CrossRefGoogle ScholarPubMed
Bornhofen, C., McDonald, S. (2008). Emotion perception deficits following traumatic brain injury: A review of the evidence and rationale for intervention. Journal of the International Neuropsychological Society, 14(4), 511525. doi:http://dx.doi.org/10.1017/S1355617708080703CrossRefGoogle ScholarPubMed
Burgess, P.W., Shallice, T. (1997). The Hayling and Brixton Tests. San Antonio, TX: Pearson PsychCorp Assessment.Google Scholar
Croker, V., McDonald, S. (2005). Recognition of emotion from facial expression following traumatic brain injury. Brain Injury, 19(10), 787799. doi:http://dx.doi.org/10.1080/02699050500110033CrossRefGoogle ScholarPubMed
Damasio, A.R. (1994). Descartes’ error and the future of human life. Scientific American, 271(4), 144.CrossRefGoogle ScholarPubMed
Darwin, C. (1872). The expression of the emotions in man and animals. London, England: John Murray.CrossRefGoogle Scholar
Davis, J.I., Senghas, A., Ochsner, K.N. (2009). How does facial feedback modulate emotional experience? Journal of Research in Personality, 43(5), 822829. doi:http://dx.doi.org/10.1016/j.jrp.2009.06.005CrossRefGoogle ScholarPubMed
de Sousa, A., McDonald, S., Rushby, J., Li, S., Dimoska, A., James, C. (2010). Why don't you feel how I feel? Insight into the absence of empathy after severe traumatic brain injury. Neuropsychologia, 48(12), 35853595. doi:10.1016/j.neuropsychologia.2010.08.008CrossRefGoogle Scholar
de Sousa, A., McDonald, S., Rushby, J., Li, S., Dimoska, A., James, C. (2011). Understanding deficits in empathy after traumatic brain injury: The role of affective responsivity. Cortex, 47(5), 526535.CrossRefGoogle ScholarPubMed
Dethier, M., Blairy, S., Rosenberg, H., McDonald, S. (2012). Spontaneous and posed emotional facial expressions following severe traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 34, 936947.CrossRefGoogle ScholarPubMed
Doherty, R. (1997). The emotional contagion scale: A measure of individual differences. Journal of Nonverbal Behavior, 21(2), 131154. doi:http://dx.doi.org/10.1023/A:1024956003661CrossRefGoogle Scholar
Doherty, R. (1998). Emotional contagion and social judgment. Motivation and Emotion, 22(3), 187209. doi:http://dx.doi.org/10.1023/A:1022368805803CrossRefGoogle Scholar
Draper, K., Ponsford, J. (2008). Cognitive functioning ten years following traumatic brain injury and rehabilitation. Neuropsychology, 22(5), 618625. doi:10.1037/0894-4105.22.5.618CrossRefGoogle ScholarPubMed
Draper, K., Ponsford, J., Schonberger, M. (2007). Psychosocial and emotional outcomes 10 years following traumatic brain injury. Journal of Head Trauma Rehabilitation, 22(5), 278287.CrossRefGoogle ScholarPubMed
Duclos, S.E., Laird, J.D. (2001). The deliberate control of emotional experience through control of expressions. Cognition and Emotion, 15(1), 2756. doi:http://dx.doi.org/10.1080/0269993004200088CrossRefGoogle Scholar
Duclos, S.E., Laird, J.D., Schneider, E., Sexter, M., Stern, L., Van Lighten, O. (1989). Emotion-specific effects of facial expressions and postures on emotional experience. Journal of Personality and Social Psychology, 57(1), 100108. doi:10.1037/0022-3514.57.1.100CrossRefGoogle Scholar
Ekman, P. (1992). Facial expressions of emotion: An old controversy and new findings. Philosophical Transactions of the Royal Society of London – Series B: Biological Sciences, 335(1273), 6369.Google ScholarPubMed
Elsass, L., Kinsella, G. (1987). Social interaction following severe closed head injury. Psychological Medicine, 17(1), 6778.CrossRefGoogle ScholarPubMed
Engberg, A.W., Teasdale, T.W. (2004). Psychosocial outcome following traumatic brain injury in adults: A long-term population-based follow-up. Brain Injury, 18(6), 533545.CrossRefGoogle ScholarPubMed
Esch, T., Fricchione, G.L., Stefano, G.B. (2003). The therapeutic use of the relaxation response in stress-related diseases. Medical Science Monitor, 9, RA23RA34.Google ScholarPubMed
Flack, W.F. (2006). Peripheral feedback effects of facial expressions, bodily postures, and vocal expressions on emotional feelings. Cognition and Emotion, 20(2), 177195. doi:http://dx.doi.org/10.1080/02699930500359617CrossRefGoogle Scholar
Flack, W.F., Laird, J.D., Cavallaro, L.A. (1999a). Emotional expression and feeling in schizophrenia: Effects of specific expressive behaviors on emotional experiences. Journal of Clinical Psychology, 55(1), 120. doi:http://dx.doi.org/10.1002/%28SICI%291097-4679%28199901%2955:1%3C1::AID-JCLP1%3E3.0.CO;2-K3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Flack, W.F., Laird, J.D., Cavallaro, L.A. (1999b). Separate and combined effects of facial expressions and bodily postures on emotional feelings. European Journal of Social Psychology, 29(2–3), 203217. doi:http://dx.doi.org/10.1002/%28SICI%291099-0992%28199903/05%2929:2/3%3C203::AID-EJSP924%3E3.0.CO;2-83.0.CO;2-8>CrossRefGoogle Scholar
Gellhorn, E. (1964). Motion and emotion: The role of proprioception in the physiology and pathologyof the emotions. Psychological Review, 71(6), 457472. doi:10.1037/h0039834CrossRefGoogle ScholarPubMed
Gosling, J., Oddy, M. (1999). Rearranged marriages: Marital relationships after head injury. Brain Injury, 13(10), 785796.Google ScholarPubMed
Grattan, L.M., Eslinger, P.J. (1989). Higher cognition and social behavior: Changes in cognitive flexibility and empathy after cerebral lesions. Neuropsychology, 3(3), 175185. doi:10.1037/h0091764Google Scholar
Green, R.E.A., Turner, G.R., Thompson, W.F. (2004). Deficits in facial emotion perception in adults with recent traumatic brain injury. Neuropsychologia, 42(2), 133141.CrossRefGoogle ScholarPubMed
Gundel, H., Lopez-Sala, A., Ceballos-Baumann, A.O., Deus, J., Cardoner, N., Marten-Mittag, B. (2004). Alexithymia correlates with the size of the right anterior cingulate. Psychosomatic Medicine, 66(1), 132140.CrossRefGoogle ScholarPubMed
Hatfield, E., Cacioppo, J.T., Rapson, R.L. (1992). Primitive emotional contagion. In M. S. Clark (Ed.), Emotion and social behavior: Review of personality and social psychology, Vol. 14, pp. 151177. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Hatfield, E., Cacioppo, J.T., Rapson, R.L. (1994). Emotional contagion. New York, NY: Cambridge University Press.Google Scholar
Herwig, U., Kaffenberger, T., Jäncke, L., Brühl, A.B. (2010). Self-related awareness and emotion regulation. Neuroimage, 50(2), 734741. doi:10.1016/j.neuroimage.2009.12.089CrossRefGoogle ScholarPubMed
Hopkins, M.J., Dywan, J., Segalowitz, S.J. (2002). Altered electrodermal response to facial expression after closed head injury. Brain Injury, 16(3), 245257.CrossRefGoogle ScholarPubMed
Houtveen, J.H., Bermond, B., Elton, M.R. (1997). Alexithymia: A disruption in a cortical network? An EEG power and coherence analysis. Journal of Psychophysiology, 11(2), 147157.Google Scholar
Jackson, H.F., Moffat, N.J. (1987). Impaired emotional recognition following severe head injury. Cortex, 23(2), 293300.CrossRefGoogle ScholarPubMed
James, W. (1890). The principles of psychology. New York, NY: Henry Holt and Co.Google Scholar
Kano, M., Fukudo, S., Gyoba, J., Kamachi, M., Tagawa, M., Mochizuki, H. (2003). Specific brain processing of facial expressions in people with alexithymia: An H2 15O-PET study. Brain, 126(Pt 6), 14741484.CrossRefGoogle ScholarPubMed
Kim, E., Lauterbach, E.C., Reeve, A., Arciniegas, D.B., Coburn, K.L., Mendez, M.F. (2007). Neuropsychiatric complications of traumatic brain injury: A critical review of the literature (A report by the ANPA committee on research). The Journal of Neuropsychiatry and Clinical Neurosciences, 19(2), 106127. doi:10.1176/appi.neuropsych.19.2.106CrossRefGoogle ScholarPubMed
Kinnunen, K.M., Greenwood, R., Powell, J.H., Leech, R., Hawkins, P.C., Bonnelle, V. (2011). White matter damage and cognitive impairment after traumatic brain injury. Brain, 134(2), 449463. doi:10.1093/brain/awq347CrossRefGoogle ScholarPubMed
Koole, S.L. (2009). The psychology of emotion regulation: An integrative review. Cognition and Emotion, 23(1), 441. doi:10.1080/02699930802619031CrossRefGoogle Scholar
Koponen, S., Taiminen, T., Honkalampi, K., Joukamaa, M., Viinamaki, H., Kurki, T. (2005). Alexithymia after traumatic brain injury: Its relation to magnetic resonance imaging findings and psychiatric disorders. Psychosomatic Medicine, 67(5), 807812.CrossRefGoogle ScholarPubMed
Laird, J.D. (1984). The real role of facial response in the experience of emotion: A reply to Tourangeau and Ellsworth, and others. Journal of Personality and Social Psychology, 47(4), 909917. doi:http://dx.doi.org/10.1037/0022-3514.47.4.909CrossRefGoogle Scholar
Laird, J.D., Alibozak, T., Davainis, D., Deignan, K., Fontanella, K., Hong, J. (1994). Individual differences in the effects of spontaneous mimicry on emotional contagion. Motivation and Emotion, 18(3), 231247. doi:http://dx.doi.org/10.1007/BF02254830CrossRefGoogle Scholar
Laird, J.D., Bresler, C. (1992). The process of emotional experience: A self-perception theory. In M. S. Clark (Ed.), Emotion (pp. 213234). Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Laird, J.D., Crosby, M. (1974). Individual differences in self-attribution of emotion. In H. London, R. E. Nisbett, & E. Richard (Eds.), Thought and feeling: Cognitive alteration of feeling states (pp. 239). Oxford, England: Aldine.Google Scholar
Lane, R.D., Ahern, G.L., Schwartz, G.E., Kaszniak, A.W. (1997). Is alexithymia the emotional equivalent of blindsight? Biological Psychiatry, 42(9), 834844. doi:10.1016/s0006-3223(97)00050-4CrossRefGoogle ScholarPubMed
Lane, R.D., Sechrest, L., Riedel, R., Shapiro, D.E., Kaszniak, A.W. (2000). Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosomatic Medicine, 62(4), 492501.CrossRefGoogle ScholarPubMed
Levenson, R.W., Ekman, P., Friesen, W.V. (1990). Voluntary facial action generates emotion-specific autonomic nervous system activity. Psychophysiology, 27(4), 363384.CrossRefGoogle ScholarPubMed
Lovibond, P.F., Lovibond, S.H. (1995). Manual for the depression anxiety stress scales. Sydney, Australia: Psychology Foundation of Australia.Google Scholar
McDonald, S., Flanagan, S., Rollins, J., Kinch, J. (2003). TASIT: A new clinical tool for assessing social perception after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 18(3), 219238. doi:http://dx.doi.org/10.1097/00001199-200305000-00001CrossRefGoogle ScholarPubMed
McDonald, S., Li, S., De Sousa, A., Rushby, J., Dimoska, A., James, C. (2011). Impaired mimicry response to angry faces following severe traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 33(1), 1729.CrossRefGoogle ScholarPubMed
McDonald, S., Rosenfeld, J., Henry, J.D., Togher, L., Tate, R.L., Bornhofen, C. (2011). Emotion perception and alexithymia in people with severe traumatic brain injury: One disorder or two? A preliminary investigation. Brain Impairment, 12(3), 165178. doi:10.1375/brim.12.3.165CrossRefGoogle Scholar
McIntosh, D.N. (1996). Facial feedback hypotheses: Evidence, implications, and directions. Motivation and Emotion, 20(2), 121147. doi:http://dx.doi.org/10.1007/BF02253868CrossRefGoogle Scholar
Medd, J., Tate, R.L. (2000). Evaluation of an anger management therapy programme following acquired brain injury: A preliminary study. Neuropsychological Rehabilitation, 10(2), 185201. doi:10.1080/096020100389246CrossRefGoogle Scholar
Morton, M.V., Wehman, P. (1995). Psychosocial and emotional sequelae of individuals with traumatic brain injury: A literature review and recommendations. Brain Injury, 9(1), 8192. doi:10.3109/02699059509004574CrossRefGoogle ScholarPubMed
Newton, A., Johnson, D.A. (1985). Social adjustment and interaction after severe head injury. British Journal of Clinical Psychology, 24(4), 225234.CrossRefGoogle ScholarPubMed
Ownsworth, T., Fleming, J. (2005). The relative importance of metacognitive skills, emotional status, and executive function in psychosocial adjustment following acquired brain injury. Journal of Head Trauma Rehabilitation, 20(4), 315332.CrossRefGoogle ScholarPubMed
Phillips, M.L., Drevets, W.C., Rauch, S.L., Lane, R. (2003). Neurobiology of emotion perception I: The neural basis of normal emotion perception. Biological Psychiatry, 54(5), 504514. doi:http://dx.doi.org/10.1016/S0006-3223%2803%2900168-9CrossRefGoogle ScholarPubMed
Reitan, R.M. (1992). Trail Making Test. Tucson, AZ: Reitan Neuropsychological Laboratories.Google Scholar
Sanchez-Navarro, J.P., Martinez-Selva, J.M., Roman, F. (2005). Emotional response in patients with frontal brain damage: Effects of affective valence and information content. Behavioral Neuroscience, 119(1), 8797.CrossRefGoogle ScholarPubMed
Saunders, J.C., McDonald, S., Richardson, R. (2006). Loss of emotional experience after traumatic brain injury: Findings with the startle probe procedure. Neuropsychology, 20(2), 224231. doi:http://dx.doi.org/10.1037/0894-4105.20.2.224CrossRefGoogle ScholarPubMed
Scheid, R., Walther, K., Guthke, T., Preul, C., von Cramon, Y. (2006). Cognitive Sequelae of Diffuse Axonal Injury. Archives of Neurology, 63(3), 418424. doi:10.1001/archneur.63.3.418CrossRefGoogle ScholarPubMed
Schnall, S., Laird, J.D. (2003). Keep smiling: Enduring effects of facial expressions and postures on emotional experience and memory. Cognition and Emotion, 17(5), 787797. doi:http://dx.doi.org/10.1080/02699930302286CrossRefGoogle Scholar
Sifneos, P.E. (1973). The prevalence of “alexithymic” characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2–6), 255262.CrossRefGoogle ScholarPubMed
Soussignan, R. (2002). Duchenne smile, emotional experience, and autonomic reactivity: A test of the facial feedback hypothesis. Emotion, 2(1), 5274. doi:http://dx.doi.org/10.1037/1528-3542.2.1.52CrossRefGoogle ScholarPubMed
Soussignan, R., Ehrle, N., Henry, A., Schaal, B., Bakchine, S. (2005). Dissociation of emotional processes in response to visual and olfactory stimuli following frontotemporal damage. Neurocase, 11(2), 114128.CrossRefGoogle ScholarPubMed
Spreen, O., Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.Google Scholar
StatSoft, I. (Producer). (2011). STATISTICA (data analysis software system), version 10. www.statsoft.com.Google Scholar
Stel, M., van den Heuvel, C., Smeets, R.C. (2008). Facial feedback mechanisms in autistic spectrum disorders. Journal of Autism and Developmental Disorders, 38(7), 12501258. doi:http://dx.doi.org/10.1007/s10803-007-0505-yCrossRefGoogle ScholarPubMed
Stepper, S., Strack, F. (1993). Proprioceptive determinants of emotional and nonemotional feelings. Journal of Personality and Social Psychology, 64(2), 211220. doi:http://dx.doi.org/10.1037/0022-3514.64.2.211CrossRefGoogle Scholar
Strack, F., Martin, L.L., Stepper, S. (1988). Inhibiting and facilitating conditions of the human smile: A nonobtrusive test of the facial feedback hypothesis. Journal of Personality and Social Psychology, 54(5), 768777. doi:http://dx.doi.org/10.1037/0022-3514.54.5.768CrossRefGoogle ScholarPubMed
Subic-Wrana, C., Bruder, S., Thomas, W., Lane, R.D., Köhle, K. (2005). Emotional awareness deficits in inpatients of a psychosomatic ward: A comparison of two different measures of alexithymia. Psychosomatic Medicine, 67(3), 483489. doi:10.1097/01.psy.0000160461.19239.13.CrossRefGoogle Scholar
Tomaiuolo, F., Carlesimo, G.A., Di Paola, M., Petrides, M., Fera, F., Bonanni, R. (2004). Gross morphology and morphometric sequelae in the hippocampus, fornix, and corpus callosum of patients with severe non-missile traumatic brain injury without macroscopically detectable lesions: A T1 weighted MRI study. Journal of Neurology, Neurosurgery, & Psychiatry, 75(9), 13141322.CrossRefGoogle ScholarPubMed
Tomkins, S.S. (1963). Affect, imagery, consciousness: vol 2. The Negative Affects. Oxford, England: Springer.Google Scholar
Wechsler, D. (1997a). Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (1997b). Wechsler Memory Scale–Third Edition. New York, NY: Psychological Corporation.Google Scholar
Wechsler, D. (2001). The Wechsler Test of Adult Reading (WTAR). New York, NY: Psychological Corporation.Google Scholar
Williams, C., Wood, R.L. (2010a). Alexithymia and emotional empathy following traumatic brain injury. Journal of Clinical & Experimental Neuropsychology, 32(3), 259267.CrossRefGoogle ScholarPubMed
Williams, C., Wood, R.L. (2010b). Impairment in the recognition of emotion across different media following traumatic brain injury. Journal of Clinical & Experimental Neuropsychology, 32(2), 113122.CrossRefGoogle ScholarPubMed
Wood, R.L., Liossi, C., Wood, L. (2005). The impact of head injury neurobehavioural sequelae on personal relationships: Preliminary findings. Brain Injury, 19(10), 845851.CrossRefGoogle ScholarPubMed
Wood, R.L., Williams, C. (2007). Neuropsychological correlates of organic alexithymia. Journal of the International Neuropsychological Society, 13(3), 471479. doi:10.1017/s1355617707070518CrossRefGoogle ScholarPubMed
Wood, R.L., Williams, C. (2008). Inability to empathize following traumatic brain injury. Journal of the International Neuropsychological Society, 14(2), 289296.CrossRefGoogle ScholarPubMed
Wood, R.L., Yurdakul, L.K. (1997). Change in relationship status following traumatic brain injury. Brain Injury, 11(7), 491501.CrossRefGoogle ScholarPubMed
Yount, R., Raschke, K.A., Biru, M., Tate, D.F., Miller, M.J., Abildskov, T. (2002). Traumatic brain injury and atrophy of the cingulate gyrus. Journal of Neuropsychiatry & Clinical Neurosciences, 14(4), 416423.CrossRefGoogle ScholarPubMed