Facial occlusion with medical masks: Impacts on emotion recognition rates for emotion types and intensities

Q J Exp Psychol (Hove). 2025 Jan 4:17470218241308569. doi: 10.1177/17470218241308569. Online ahead of print.

Abstract

During the COVID-19 pandemic, mask-wearing became prominent or required worldwide as a predominant preventive strategy up until and even after vaccines became widely available. Because masks make emotion recognition more challenging for both the face and voice, medical and behavioural/mental health providers became aware of the disruptions this generated in practitioner-patient relationships. The current set of studies utilised two adult samples, first from United States college students (N = 516) and second from the U.S. American general public (N = 115), to document the severity and types of errors in facial expression recognition that were exacerbated by medical mask occlusion. Using a within-subjects experimental design and a well-validated test of emotion recognition that incorporated multiethnic adult facial stimuli, both studies found that happy, sad, and angry faces were significantly more difficult to interpret with masks than without, with lesser effects for fear. Both high- and low-intensity emotions were more difficult to interpret with masks, with a greater relative change for high-intensity emotions. The implications of these findings for medical and behavioural/mental health practitioners are briefly described, with emphasis on strategies that can be taken to mitigate the impact in health care settings.

Keywords: COVID-19; Emotion recognition; facial occlusion; mask attitude scale; masking.