PTSD’s Effects on Social Interaction

Post-traumatic stress disorder (PTSD) is a mental health condition that can appear when any given individual experiences events or situations that overwhelm the brain’s stress-related coping mechanisms and make certain damaging changes in ongoing mental function.

The events and situations that can produce these kinds of changes typically involve some form of violence or physical transgression, or heavily implied threats of violence or transgression. Current evidence indicates that a previously unrecognized consequence of PTSD is loss of some of the ability to process or identify certain common emotional cues that pass between people during social interactions.

PTSD Basics

The American Psychiatric Assn. groups PTSD and several other mental health conditions—including obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD)—into a category of illnesses known as anxiety disorders. Generally speaking, these disorders produce lasting feelings of uncertainty, worry and fear in affected individuals. Symptoms specifically associated with the presence of PTSD include involuntarily replaying or reliving the traumatic event that originally triggered the disorder, actively avoiding situations that resemble or recreate features of the original event, experiencing memory lapses regarding the original trauma, and developing an unusual state of alertness (called hypervigilance) designed to detect or prevent future sources of trauma. The intensity and duration of these symptoms can vary considerably from person to person. However, all people with PTSD have problems that are severe enough to diminish their ability to participate in everyday life.

People with PTSD commonly display an increase in something that mental health professionals call negative affect. This term refers to the onset of a group of emotions that produce strong forms of “negative” responses such as disliking or a desire for avoidance. Specific emotions capable of producing these types of responses commonly include fear, anger, contempt, guilt, nervousness and disgust. Generally speaking, any given individual’s level of discomfort and anxiety rises when his or her level of negative affect rises.

Emotional Cue Basics

Emotional cues are outward signs of emotional intent that human beings naturally look for when interacting with each other. Without the presence of these cues, social interactions become much more unpredictable; for this reason, people involved in interactions that lack the appropriate cues may feel lost or develop insecurities that destabilize their sense of well-being. Some important social cues stem from the facial expressions that indicate the presence of basic emotional states such as happiness, sadness, disgust, fear, anger, and surprise. Other important cues stem from the body language that accompanies various types of facial expressions. Interestingly, not all cultures have the same emotional cues or place the same emphasis on the importance of specific types of cues.

Emotional Cue Alteration

In part because of its ability to produce an increase in negative affect, PTSD is well-known for its ability to produce significant disruptions in an individual’s ability to experience emotions, properly identify emotions internally, or accurately describe his or her emotional state to others. In a study published in 2011 in the journal Cortex, a multi-university European research team examined the effects of PTSD on the ability to recognize the various facial expressions commonly used to establish emotional cues during social interactions. As noted previously, the basic emotional states represented by these expressions are anger, surprise, disgust, fear, happiness and sadness.

In order to test the cue-reading abilities of people with PTSD, the research team showed a group of PTSD-affected war veterans a series of short films, each one of which exemplified one the six basic emotions. While the study participants had no difficulty recognizing happiness, surprise, anger, or disgust on the faces of others, they showed a significant decline in their ability to accurately recognize the presence of sadness and fear. No previous study had demonstrated such a specific loss in the emotional capabilities of people affected by PTSD.


An inability to reliably recognize the emotional cues of others may go a long way toward explaining the social anxiety commonly experienced by people with PTSD. The authors of the study published in “Cortex” believe that their findings are also important on several additional levels. First, they provide a previously unencountered level of insight into the specific ways in which post-traumatic stress alters normal brain function. They may also point the way toward improvements in current methods of assessing people with PTSD, as well as improvements in the ability to predict the course of PTSD symptoms. In addition, increased knowledge about the emotional deficits produced by PTSD may lead to an improvement in the psychotherapeutic or medication-based options currently used to treat the disorder.