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Concept: Metacommunicative competence



Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile’s angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent. We define a “successful smile” as one that is rated effective, genuine, and pleasant in the colloquial sense of these words. We found that a successful smile can be expressed via a variety of different spatiotemporal trajectories, involving an intricate balance of mouth angle, smile extent, and dental show combined with dynamic symmetry. These findings have broad applications in a variety of areas, such as facial reanimation surgery, rehabilitation, computer graphics, and psychology.

Concepts: Psychology, Computer graphics, Communication, Paul Ekman, 3D computer graphics, Nonverbal communication, Metacommunicative competence, Eye contact


Facial expressions of emotion are thought to have evolved from the development of facial muscles used in sensory regulation and later adapted to express moral judgment. Negative moral judgment includes the expressions of anger, disgust and contempt. Here, we study the hypothesis that these facial expressions of negative moral judgment have further evolved into a facial expression of negation regularly used as a grammatical marker in human language. Specifically, we show that people from different cultures expressing negation use the same facial muscles as those employed to express negative moral judgment. We then show that this nonverbal signal is used as a co-articulator in speech and that, in American Sign Language, it has been grammaticalized as a non-manual marker. Furthermore, this facial expression of negation exhibits the theta oscillation (3-8Hz) universally seen in syllable and mouthing production in speech and signing. These results provide evidence for the hypothesis that some components of human language have evolved from facial expressions of emotion, and suggest an evolutionary route for the emergence of grammatical markers.

Concepts: Gene expression, Sentence, Morality, Paul Ekman, Nonverbal communication, Sign language, Facial expression, Metacommunicative competence


Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient/surrogate-provider communication may contribute to this phenomenon.

Concepts: Life, Intensive care medicine, Physician, Writing, Communication, Nonverbal communication, Paralanguage, Metacommunicative competence


Loss of verbal language production makes people with dementia appear unreachable. We previously presented a case study applying nonverbal communication techniques with a lady with dementia who could no longer speak, which we termed Adaptive Interaction. The current small-n study examines the applicability of Adaptive Interaction as a general tool for uncovering the communication repertoires of non-verbal individuals living with dementia. Communicative responses of 30 interaction sessions were coded and analysed in two conditions: Standard (Baseline) and Adaptive Interaction (Intervention). All participants retained the ability to interact plus a unique communication repertoire comprising a variety of nonverbal components, spanning eye gaze, emotion expression, and movement. In comparison to Baseline sessions, Intervention sessions were characterised by more smiling, looking at ME and imitation behaviour from the people with dementia. These findings allude to the potential of Adaptive Interaction as the basis for interacting with people living with dementia who can no longer speak.

Concepts: Writing, Communication, Paul Ekman, Nonverbal communication, Paralanguage, Metacommunicative competence


Deficits in the perception of social cues are common in schizophrenia and predict functional outcome. While effective communication depends on deciphering both verbal and non-verbal features, work on non-verbal communication in the disorder is scarce.

Concepts: Writing, Communication, Nonverbal communication, Paralanguage, Metacommunicative competence


Smooth social communication consists of both verbal and non-verbal information. However, when presented with incongruence between verbal information and nonverbal information, the relationship between an individual judging trustworthiness in those who present the verbal-nonverbal incongruence and the brain activities observed during judgment for trustworthiness are not clear. In the present study, we attempted to identify the impact of incongruencies between verbal information and facial expression on the value of trustworthiness and brain activity using event-related potentials (ERP). Combinations of verbal information [positive/negative] and facial expressions [smile/angry] expressions were presented randomly on a computer screen to 17 healthy volunteers. The value of trustworthiness of the presented facial expression was evaluated by the amount of donation offered by the observer to the person depicted on the computer screen. In addition, the time required to judge the value of trustworthiness was recorded for each trial. Using electroencephalography, ERP were obtained by averaging the wave patterns recorded while the participants judged the value of trustworthiness. The amount of donation offered was significantly lower when the verbal information and facial expression were incongruent, particularly for [negative × smile]. The amplitude of the early posterior negativity (EPN) at the temporal lobe showed no significant difference between all conditions. However, the amplitude of the late positive potential (LPP) at the parietal electrodes for the incongruent condition [negative × smile] was higher than that for the congruent condition [positive × smile]. These results suggest that the LPP amplitude observed from the parietal cortex is involved in the processing of incongruence between verbal information and facial expression.

Concepts: Brain, Temporal lobe, Cerebrum, Electroencephalography, Nonverbal communication, Facial expression, Metacommunicative competence, Eye contact


In the interests of patient health outcomes, it is important for medical students to develop clinical communication skills. We previously proposed a telehealth communication skills training platform (EQClinic) with automated nonverbal behavior feedback for medical students, and it was able to improve medical students' awareness of their nonverbal communication.

Concepts: Clinical trial, Crossover study, Learning, Writing, Communication, Nonverbal communication, Paralanguage, Metacommunicative competence


There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training.

Concepts: Writing, Communication, Nonverbal communication, Sign language, Emergency department, Trauma team, Paralanguage, Metacommunicative competence


Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the non-verbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship.

Concepts: Therapy, Writing, Communication, Nonverbal communication, Paralanguage, Metacommunicative competence