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MPI Series in
Biological Cybernetics
No. 43, May 2015

Janina Esins
Face processing in
congenital prosopagnosia
Face processing in congenital prosopagnosia

Dissertation

zur Erlangung des Grades eines


Doktors der Naturwissenschaften

der Mathematisch-Naturwissenschaftlichen Fakultät


und
der Medizinischen Fakultät
der Eberhard-Karls-Universität Tübingen

vorgelegt
von

Janina Esins
aus Schwerin, Deutschland

February – 2015
Bibliografische Information der Deutschen Nationalbibliothek

Die Deutsche Nationalbibliothek verzeichnet diese Publikation in der


Deutschen Nationalbibliografie; detaillierte bibliografische Daten sind
im Internet über http://dnb.d-nb.de abrufbar.

c Copyright Logos Verlag Berlin GmbH 2015


Alle Rechte vorbehalten.

ISBN 978-3-8325-3983-2

Logos Verlag Berlin GmbH


Comeniushof, Gubener Str. 47,
10243 Berlin
Tel.: +49 (0)30 42 85 10 90
Fax: +49 (0)30 42 85 10 92
INTERNET: http://www.logos-verlag.de
Tag der mündlichen Prüfung: 23. April 2015.

Dekan der Math.-Nat. Fakultät: Prof. Dr. W. Rosenstiel


Dekan der Medizinischen Fakultät: Prof. Dr. I. B. Autenrieth

1. Berichterstatter: Prof. Dr. Heinrich H. Bülthoff


2. Berichterstatter: Dr. Andreas Bartels
Prüfungskommission: Prof. Dr. Martin A. Giese
Dr. Andreas Bartels
Prof. Dr. Christóbal Curio
Prof. Dr. Nikolaus F. Troje

III
I hereby declare that I have produced the work entitled: “Face processing in
prosopagnosia”, submitted for the award of a doctorate, on my own (without external
help), have used only the sources and aids indicated and have marked passages included
from other works, whether verbatim or in content, as such. I swear upon oath that these
statements are true and that I have not concealed anything. I am aware that making a false
declaration under oath is punishable by a term of imprisonment of up to three years or by
a fine.

Janina Esins

IV
Acknowledgements

First and foremost, I thank Dr. Isabelle Bülthoff and Dr. Johannes Schultz for their great
supervision. Their constant support and encouragement helped me through some difficult
phases of this thesis. And I am grateful for their patience in endless rounds of revisions
during which they had to bear and improve my intellectual effusions.

I also thank Dr. Heinrich H. Bülthoff for giving me the opportunity to work at
outstanding research facilities, the Max Planck Institute for Biological Cybernetics and
the Department of Brain and Cognitive Engineering at the Korea University in Seoul. I
very much enjoyed the great time at these amicable environments.

I would also like to acknowledge Prof. Martin Giese, and Dr. Andreas Bartels, as
members of my advisory board, for comments and fruitful discussions of my work.

I owe special thanks to several other people helping to conduct my studies: Christian
Wallraven for very interesting and fruitful discussions; Stephan de la Rosa for answering
all my statistic questions; Karin Bierig for helping to conduct some experiments; Walter
Heinz, Mirko Thiesen and Timo Hertel for making diverse computer problems easier to
endure; Jacqueline Matzkeit and Katrin Prax for their incredibly efficient processing of
necessary organizational duties; Joachim Tesch, Nina Gaißert, and Christoph Dahl for
helping me out with stimuli; and Nele Hellbernd, Nack Duangkamol Srismith, BoRa Kim
and Lea Ottenberger for helping me to create some other stimuli.

And of course I thank the whole MPI crowd for making working at the MPI so much fun
with movie nights and holiday trips, coffee and tea breaks, fruitful scientific and private
discussions, and several very interesting conversations over lunch ;) Thanks!

Most of all, I would like to express my deepest gratitude to my family, for always being
there for me and supporting me in every way. You are always the first to call when
something terrible happened; or something awesome. I am grateful for everything you
have done for me. I love you.

V
VI
Summary

Face recognition is one of the most important abilities for everyday social interactions.
Congenital prosopagnosia, also referred to as "face blindness", describes the innate,
lifelong impairment to recognize other people by their face. About 2 % of the population
is affected, which means that one in fifty people shows noticeable problems in face
recognition.

This thesis aimed to investigate different aspects of face processing in prosopagnosia in


order to gain a clearer picture and a better understanding of this heterogeneous
impairment. In a first study, various aspects of face recognition and perception were
investigated to allow for a better understanding of the nature of prosopagnosia. The
results replicated previous findings and helped to resolve discrepancies between former
studies. In addition, it was found that prosopagnosics show an irregular response behavior
in tests for holistic face recognition. We propose that prosopagnosics either switch
between strategies or respond randomly when performing these tests. In a second study,
the general face recognition deficit observed in prosopagnosia was compared to face
recognition deficits occurring when dealing with other-race faces. Most humans find it
hard to recognize faces of an unfamiliar race, a phenomenon called the "other-race
effect". The study served to investigate if there is a possible common mechanism
underlying prosopagnosia and the other-race effect, as both are characterized by problems
in recognizing faces. The results allowed to reject this hypothesis, and yielded new
insights about similarities and dissimilarities between prosopagnosia and the other-race
effect. In the last study, a possible treatment of prosopagnosia was investigated. This was
based on a single case in which a prosopagnosic reported a sudden improvement of her
face recognition abilities after she started a special diet.

The different studies cover diverse aspects of prosopagnosia: the nature of prosopagnosia
and measurement of its characteristics, comparison to other face recognition impairments,
and treatment options. The results serve to broaden the knowledge about prosopagnosia
and to gain a more detailed picture of this impairment.

VII
VIII
Contents

I. Synopsis ........................................................................................................................ 1
1. Face recognition ........................................................................................................ 2
1.1. Holistic processing ............................................................................................ 2
1.2. The other-race effect .......................................................................................... 3
2. Congenital prosopagnosia ......................................................................................... 3
2.1. Forms and occurrence frequency of prosopagnosia .......................................... 4
2.2. Manifestations of prosopagnosia ....................................................................... 4
2.3. Neurophysiological and genetic basis of congenital prosopagnosia ................. 6
2.4. Treatments of prosopagnosia ............................................................................. 8
3. Thesis overview and discussion ................................................................................ 8
3.1. Motivation ......................................................................................................... 8
3.2. Test battery ........................................................................................................ 9
3.3. Face perception and test reliability in prosopagnosia ...................................... 10
3.4. Comparing the other-race effect and prosopagnosia ....................................... 11
3.5. Galactose uncovers face recognition ............................................................... 13
3.6. Search for subgroups ....................................................................................... 16
3.7. General discussion ........................................................................................... 16
4. Outlook ................................................................................................................... 18
References ...................................................................................................................... 19
Declaration of Contribution ........................................................................................... 30

II. Face perception and test reliabilities in congenital prosopagnosia in seven tests ...... 33
1. Abstract ................................................................................................................... 33
2. Introduction ............................................................................................................. 34
3. General methods ..................................................................................................... 35
3.1. Procedure ......................................................................................................... 35
3.2. Participants ...................................................................................................... 35
3.3. Analysis ........................................................................................................... 37

IX
4. Tests ........................................................................................................................ 38
4.1. Cambridge Face Memory Test ........................................................................ 38
4.2. Cambridge Car Memory Test .......................................................................... 39
4.3. Surprise recognition task ................................................................................. 42
4.4. Surprise recognition task ................................................................................. 46
4.5. Featural and configural sensitivity task ........................................................... 51
4.6. Gender recognition task ................................................................................... 55
4.7. Facial motion advantage .................................................................................. 58
5. Reliabilities ............................................................................................................. 66
6. General discussion .................................................................................................. 69
Summary..................................................................................................................... 71
References ...................................................................................................................... 71

III. Do congenital prosopagnosia and the other-race effect affect the same face
recognition mechanisms? ................................................................................................... 83
1. Abstract ................................................................................................................... 83
2. Introduction ............................................................................................................. 84
3. Materials and methods ............................................................................................ 88
3.1. Participants ...................................................................................................... 88
3.2. Analysis ........................................................................................................... 90
3.3. Apparatus ......................................................................................................... 91
3.4. Procedure ......................................................................................................... 91
4. Test battery.............................................................................................................. 92
4.1. Cambridge face memory test ........................................................................... 92
4.2. Similarity rating of faces differing in features and configuration ................... 93
4.3. Object recognition ......................................................................................... 104
5. Correlations between tests .................................................................................... 109
6. General discussion ................................................................................................ 110
Acknowledgements ...................................................................................................... 113
Supplementary material................................................................................................ 113
References .................................................................................................................... 113

X
IV. Galactose uncovers face recognition and mental images in congenital
prosopagnosia: The first case report ................................................................................ 121
1. Abstract ................................................................................................................. 121
2. Introduction ........................................................................................................... 122
3. Report of the case.................................................................................................. 122
4. Comment ............................................................................................................... 123
Ethics ............................................................................................................................ 124
References .................................................................................................................... 125

XI
XII
I. Synopsis

I. Synopsis

Our faces tell who we are. When seeing a picture of a whole person without the face, the
picture seems incomplete, and the person is unrecognizable in most cases. In contrast, a
portrait showing just a face is perceived as a representation of the whole person. Our face
carries our identity. It therefore bears great social importance. We do not only recognize
people by their face, we also gain information about their age, gender, mood, and even
judge their attractiveness and trustworthiness. Furthermore, faces contain a unique
amount of social signals, like facial expressions, eye gaze direction, or attentional focus.
These social signs are the most important cues that we use for everyday interaction with
others.

The performance and reliability of our face recognition system is unrivaled by our other
recognition systems, for example for objects. It is robust in correctly identifying a face in
different lighting conditions, after years of ageing, or weight changes. At the same time, it
is sensitive enough to distinguish within a split second between the thousands of faces of
acquaintances and celebrities we know . Our face recognition system is so reliable that we
only notice how important it is when it fails. The condition of a general impairment of
face recognition is called 'prosopagnosia'.

This thesis examines various aspects of prosopagnosia, more precisely congenital


prosopagnosia, the inborn form of the face recognition impairment. In three studies we
investigated in what way congenital prosopagnosia impairs face processing, if it relates to
other face recognition disturbances, and if it might be treatable.

This synopsis will first provide some background information on face processing in
general and potential disturbances of it. Then information about prosopagnosia will be
presented: its different manifestations, neurological causes, and possible treatments.
Thirdly, the overall scope of this thesis and the findings of its three studies will be

1
Face recognition

discussed in relation to previous work. The synopsis will be followed by three papers
describing the methods, results and findings of the three studies in more detail.

1. Face recognition

Faces are a very homogeneous object category, with eyes, nose, and mouth (features)
arranged in a very similar way in all humans. This homogeneity of faces asks for
specialized means in order to discriminate them from each other, e.g. to detect the subtle
changes in form of the facial features and their spatial arrangement (configuration). A
hypothesis about how humans achieve this outstanding performance in face recognition is
that faces are processed holistically (Farah et al., 1998).

1.1. Holistic processing

Holistic processing of faces means that the different components of a face (e.g., features
and their configuration) are merged into a whole. It is very difficult to process single parts
of a face individually without integrating other facial information (Maurer et al., 2002),
and there is less part decomposition compared to object recognition (Tanaka and Farah,
1993; Lobmaier et al., 2010). One well-known demonstration of holistic face processing
is the composite face illusion (Young et al., 1987). The top face half of one person
combined with the bottom face half of another person gives the impression of a new, third
identity. It is very hard to process the two different parts individually to identify the
original persons (Figure 1), even if they are well-known to the viewer. Misaligning the
two face halves makes the illusion disappear.

A B

Figure 1: (A) Composite illusion. Aligning the top and bottom face half of two individuals
creates the illusion of a new, third person. Misaligning the two halves makes the illusion
disappear. (B) Original faces used for the illusion in panel A.

2
I. Synopsis

As holistic processing depends on the integration of the different dimensions of facial


information (e.g. features, configuration, etc.), the disturbance in retrieval of information
from any of these dimensions impairs holistic processing and thus face recognition. This
has been shown for example in studies using blurred and scrambled face stimuli, in which
either featural or configural information are respectively disrupted (Collishaw and Hole,
2000).

1.2. The other-race effect

One example of deficits in face recognition, known by nearly every human, can be
experienced when looking at other-race faces. Faces of a foreign ethnicity are harder to
distinguish from each other than faces of the own, familiar ethnicity (Malpass and
Kravitz, 1969). This phenomenon is called the 'other-race effect', 'own-race-bias', or
'cross-race effect'. One possible and widely accepted explanation for this effect is the
higher level of expertise for same-race faces compared with other-race faces (Meissner
and Brigham, 2001).

Studies have shown, that other-race faces are processed less holistically than own-race
faces (Michel et al., 2006b), and that there is an own-race advantage for both configural
and featural processing (Hayward et al., 2008). These findings support the hypothesis that
face recognition is compromised if holistic processing or processing of some of the facial
information (e.g. features, configuration, etc.) is impaired.

Congenital prosopagnosia, a more severe impairment of face recognition, is the research


focus of this thesis and will be discussed in the next section.

2. Congenital prosopagnosia

A general impairment of face recognition is summarized under the term ‘prosopagnosia’.


The term 'prosopagnosia' comes from the two Greek words ‘prosopo’ (πρόσωπο) which
means ‘face’ and ‘agnosia’ (αγνωσία) which means ‘not knowing’. Prosopagnosia is also
often referred to as ‘face blindness’, though this term can be misleading. Even though
prosopagnosics cannot read the identity coded by a face, or only with great effort, they
are able to see and detect faces (Garrido et al., 2008).

3
Congenital prosopagnosia

2.1. Forms and occurrence frequency of prosopagnosia

Prosopagnosia can be acquired, caused by an acute brain lesion damaging a previously


functioning face recognition system. However, this thesis investigates the congenital,
innate form of prosopagnosia: in the people affected, the face recognition system never
developed or worked normally. Approximately 2 % of the population is affected by this
form of prosopagnosia (Kennerknecht et al., 2006; Kennerknecht et al., 2008a). Several
aspects of the impairment indicate that congenital prosopagnosia might be hereditary
(Grüter, 2004), as many investigated cases have first-order relatives, who also exhibit
face recognition deficits (e.g. Kennerknecht et al., 2008b; Schmalzl et al., 2008a).
Another term to refer to prosopagnosia with an early onset is ‘developmental’
prosopagnosia. This term is often used interchangeably with ‘congenital’ prosopagnosia
(Duchaine et al., 2007a); however, it is occasionally used to refer to instances where
prosopagnosia was likely acquired in early childhood, due to brain damage (Barton et al.,
2003). For this reason, in this thesis the term 'congenital' is used to underline the innate,
lesion-free form of prosopagnosia for the participants of the studies. Participants' self-
testimony or parents' testimony was used to determine the lack of brain lesions.
Additionally, in many cases participants reported first-order relatives with face
recognition impairments, strengthening the classification as hereditary, congenital form of
prosopagnosia. In the further course of this thesis, 'prosopagnosia' will refer to the
congenital from, if not stated otherwise.

2.2. Manifestations of prosopagnosia

The degree of impairment severity differs between prosopagnosics. Very likely, face
recognition ability is Gaussian distributed among the population with prosopagnosics at
the low end of the spectrum (Russell et al., 2009; Kennerknecht et al., 2011). At the other
end of the spectrum are so-called super recognizers, who are able to recognize a face after
decades, even if they have just very briefly met that person (Russell et al., 2009)
(Figure 2).

In most studies, prosopagnosia is diagnosed if the performance in face recognition tests is


two standard deviations below the mean performance of a control population. No
standard tests exist for the diagnosis of prosopagnosia; however, it became common
practice to use the Cambridge Face Memory Test (CFMT, Duchaine and Nakayama
(2006)), mostly in combination with further face recognition tests, like tests of famous

4
I. Synopsis

face recognition and face perception (Rivolta et al., 2011; Tree and Wilkie, 2010; Shah et
al., 2015). In addition, other means of diagnosis exist, for example questionnaires (Grüter,
2004; Stollhoff et al., 2011).

Figure 2: Graphical representation of the possible normal distribution of face recognition ability.
Performance outliers are prosopagnosics (low end of the scale) and super recognizers (high end of
the scale).

Prosopagnosia includes all cases with generally impaired face recognition, no matter what
the underlying cause is. A study found a prevalence of subjectively perceived face
recognition difficulties in 47 % of participants with Asperger's syndrome compared to
11 % of controls (Nieminen-von Wendt et al., 2005). Another study investigating the
comorbidity of prosopagnosia in patients with social developmental disorders found that
some, but not all participants had impaired face recognition compared to controls (Barton
et al., 2004). Some patients with schizophrenia were found to have impaired face
recognition (Archer et al., 1992), as well as adults with attention deficit hyperactive
disorder (ADHD) (Markovska-Simoska and Pop-Jordanova, 2010).

Several studies have investigated the nature of impairments occurring in prosopagnosia


and what impact prosopagnosia has on different aspects of face recognition. As with the
other-race effect, it has been shown that prosopagnosia impairs holistic face processing in
general (Avidan et al., 2011), as well as configural and featural processing in particular
(Hayward et al., 2008). However, the results were mixed, with prosopagnosics showing
large variations in impairments. In addition, when assessed with several tests,
prosopagnosics showed no systematic pattern of impairment: They were impaired in
some tests and performed normally in others, without a clear structure at the individual
and group level, and without relation to their face recognition in the 'real world' (Le

5
Congenital prosopagnosia

Grand et al., 2006; Schweich and Bruyer, 1993). The pattern of impairments even varies
across prosopagnosics belonging to the same family, for which one would expect similar
traits and impairment patterns (Schmalzl et al., 2008a). Investigated aspects with non-
uniform findings include holistic processing (e.g. assessed by the composite face test),
processing of features and configuration, recognition of facial expression, recognition of
gender, judgment of attractiveness, viewpoint matching, etc. All cases of prosopagnosia
have in common that their face recognition is impaired, but more specific impairments
strongly vary from case to case.

Due to their difficulties in recognizing faces, prosopagnosics develop different


recognition strategies based on means like distinctive facial features (e.g. aquiline nose,
thick eyebrows), voice, hairdo, gait or obvious facial blemishes to recognize someone
(Rodrigues et al., 2008; Mayer and Rossion, 2009). Of course, these strategies for face
recognition are also used in face recognition tests (Stollhoff, 2010; Duchaine et al., 2003).
By applying their compensatory strategies, some prosopagnosics have been reported to
obtain 'normal' scores in the CFMT (Bate et al., 2013) and in famous face recognition
tests (Rodrigues et al., 2008). These strategies could potentially falsify tests results, being
one source of the heterogeneity of the impairment. To the best of our knowledge, this
problem has not yet been investigated. However, strategies cannot explain all findings of
heterogeneity: a study testing very young, related prosopagnosics (4, 5, and 8 years of
age) also found heterogeneous impairment patterns (Schmalzl et al., 2008a). The authors
concluded that the heterogeneity is genetically intrinsic to prosopagnosia, rather than a
result of strategies developed during life, as the participants were too young to have
developed consistent strategies.

2.3. Neurophysiological and genetic basis of congenital prosopagnosia

Face recognition involves several interconnected brain regions, the so-called 'face
processing network'. This network has three core areas in each hemisphere (see Figure 3).
The fusiform face area (FFA) is located in the lateral fusiform gyrus of the temporal lobe
and is believed to process facial identity (Kanwisher and Yovel, 2006). Another core face
area is the occipital face area (OFA) which is located in the inferior occipital gyrus. The
OFA has been linked to the early visual processing of faces (Pitcher et al., 2011) and to
providing input to the FFA (Haxby et al., 2000). The third core area for face recognition
is the superior temporal sulcus (STS) which processes biological and facial motion and

6
I. Synopsis

gaze direction (Allison et al., 2000; Hoffman and Haxby, 2000). This core network is
extended by further face areas processing person knowledge, emotional aspects, etc.
(Ishai et al., 2005).

STS STS

OFA FFA

FFA OFA

View: sagittal (from the side) coronal (from behind) axial (from top)

Figure 3: Overview of the core areas of the face network and their approximate position in the
authors brain.

Brain activity measurement techniques like electro-encephalography (EEG) or magnetic


resonance imaging (MRI) help to shed light onto the underlying neurophysiological
causes of prosopagnosia. Several studies investigating prosopagnosics found reduced grey
matter volume in several regions or in the whole of the temporal lobe (Bentin et al., 1999;
Behrmann et al., 2007; Garrido et al., 2009). Furthermore, structural connections between
STS and other core face areas were reported to be reduced in prosopagnosics (Thomas et
al., 2009; Pyles et al., 2013), as was the diffusivity of the tracts connecting the FFA with
the other core face areas (Gomez et al., 2015). Whether the reduced volume of, and
connectivity between, the core faces areas in prosopagnosia are causes or consequences
of prosopagnosia remains an open question.

The occurrence pattern of prosopagnosia within families was first interpreted as


indication for an autosomal dominant inheritance process (i.e. if one parent is affected,
chances are 50 % for each child to be affected as well) (Grüter et al., 2007). However,
potential candidate genes remain to be identified. Finding the candidate genes and their
role in developing or maintaining face recognition will be a dramatic breakthrough in the
understanding of cognition and may even result in treatment opportunities for
prosopagnosia.

7
Thesis overview and discussion

2.4. Treatments of prosopagnosia

Several attempts have been made to improve face recognition in the acquired as well as
the congenital forms of prosopagnosia. Two different approaches have been undertaken
so far to treat congenital prosopagnosia: (1) training to improve face recognition, and (2)
some form of 'medication'.

(1) In some cases, the training was aimed at helping to identify unique facial
characteristics useful to learn and recognize faces (Brunsdon et al., 2006; Schmalzl et al.,
2008b). In both studies, training only brought improvement for the trained faces and a
generalization to untrained faces was not possible. In other cases, training was aimed at
helping prosopagnosics to improve their holistic face processing by extracting spatial
information (DeGutis et al., 2014). The results were mixed with some of the
prosopagnosics being able to raise their performance level to that of controls, while some
prosopagnosics were not able to improve their performance at all.

(2) So far there is only one study that has reported treating prosopagnosics using some
form of 'medication': the hormone oxytocin (Bate et al., 2013). Oxytocin has been found
to be crucial for various social behaviors (Lee et al., 2009) and seems to enhance memory
for faces (Savaskan et al., 2008). In the study by Bate and colleagues (2013) some
prosopagnosics significantly, temporarily improved their face recognition performance
while others showed only very little to no improvement.

3. Thesis overview and discussion

3.1. Motivation

The described heterogeneity of prosopagnosia in its manifestations, and its response to


treatments gave rise to the topic of this thesis. Due to the conflicting results reported in
previous studies and the heterogeneous pattern of impairments, the possible existence of
subgroups in prosopagnosia was proposed (e.g. Avidan et al., 2011). However, why
subgroups might exist had never been specified. The discovery of the genes responsible
for the different subgroups would be a quantum leap in the research field. Unfortunately,
the search for possible candidate genes might prove more difficult than anticipated, if, for
example, prosopagnosia is a symptom resulting from various causes. For this reason, a

8
I. Synopsis

categorization into subgroups might help to pre-sort the individual prosopagnosic cases,
before searching for common genetic factors within the subgroups. Therefore, the goal of
this thesis was to create an extended test battery to investigate the heterogeneous patterns
of impairments in prosopagnosia in more detail, to broaden and expand the understanding
of this disorder, and to investigate the possibility to detect at least some subgroups based
on their pattern of impairments in psychophysical tests.

3.2. Test battery

To achieve the goals of this thesis, an extended battery containing 16 tests was designed.
The test battery consists of a mix of face and object recognition test, some well-
established and some newly created, as well as some tests known from previous studies to
yield non-uniform results for prosopagnosic participants. Especially the latter category of
tests was considered helpful to detect different forms of prosopagnosia, thus facilitating
the search for subgroups. The battery was used to test a comparatively high number of
prosopagnosics1 as well as age-, gender and education matched controls and other-race
observers.

The test battery consists of 16 tests (references are given for tests and stimuli graciously
provided by other researchers):

1. Cambridge Face Memory Test (CFMT), a test of face memory and holistic
processing (Duchaine and Nakayama, 2006b)
2. Cambridge Car Memory Test (CCMT), a test of object memory and processing
(Dennett et al., 2011)
3. Surprise recognition test, a test of holistic processing and the unconscious intake of
facial identity information
4. Composite face test, a test of holistic processing
5. Similarity rating test, a test of the sensitivity to featural and configural facial
information
6. Face gender test, a test of gender recognition on the basis of the face

1
The prosopagnosic participants were diagnosed by the Institut für Humangenetik, Westfälische-
Wilhelms-Universität, Münster, Germany, based on a screening questionnaire and a diagnostic
semi-structured interview (Stollhoff et al., 2011).

9
Thesis overview and discussion

7. Facial motion advantage test, a test of holistic processing and the advantage of
dynamic information on face recognition (O’Toole et al., 2005)
8. Object and face test, a test of object and face recognition
9. Other-race test, a test of holistic processing and recognition of own- and other-race
faces (Michel et al., 2006a)
10. Covert face recognition, a test of holistic processing and implicit, unconscious face
recognition
11. Face categorization test, a test of holistic versus feature-based processing of faces
(Schwarzer et al., 2005)
12. Facial idiosyncrasy test, a test of face recognition based purely on facial motion
(Dobs et al., 2015)
13. Navigation test, a test of the sense of orientation
14. Long term memory test, a test of the long term memory (i.e. 2 years) of faces and
objects
15. Facial imagery, a test of the mental imagination ability for faces
16. Famous face test, a test of holistic processing and recognition of familiar faces

This test battery was used to conduct two studies. One study investigated the nature of the
heterogeneous manifestations of prosopagnosia and if it is possible to detect potential
subgroups based on the performance in those tests. This study is described in detail in
chapter II. Another study compared two phenomena of impaired face recognition
performance: prosopagnosia and the other-race effect. This study is described in detail in
chapter III.

A last study investigated the occurrence of improvement of face recognition abilities in a


single prosopagnosic case. This study is described in chapter IV. All three studies are
summarized in the following sections, followed by two sections describing the search for
subgroups and generally discussing the results of the research conducted for this thesis.

3.3. Face perception and test reliability in prosopagnosia

In the study described in chapter II, we investigated different aspects of face perception
with tests 1 to 7 (listed on page 9) for prosopagnosic and control participants. Besides

10
I. Synopsis

analyzing the test performance, we also compared the reliability of the different tests
across participant groups.

As a group, prosopagnosics showed a number of perceptual impairments compared to


controls: impaired holistic processing impaired processing of featural and configural
information of faces, impaired performance in gender recognition, and a reduced
advantage for recognition of faces in motion. There was no difference between groups in
object recognition and in the unconscious intake of face identity information. These
results mostly confirmed our expectations and some tests replicated or confirmed findings
of previous studies.

For each test, we calculated its internal consistency reliability, which is an indication of
the test's quality: the trials of a test measuring the same face recognition mechanisms
should produce similar scores. We were surprised to find different reliability coefficients
between groups: prosopagnosics showed much lower reliability coefficients than controls
in tests of holistic face processing. This suggests that the prosopagnosic participants had a
different response behavior quality, exhibiting a very irregular and changing response
behavior within these tests. A possible explanation is that prosopagnosics switch between
strategies or respond randomly.

This finding has implications for the interpretation of prosopagnosics' test results. First,
individual test scores are used in the literature to compare prosopagnosics with controls;
second, they are used to compare prosopagnosics with each other; and third, they are used
to analyze prosopagnosics' response patterns in order to characterize their impairment and
search for subgroups. We believe that the cause for this reduced reliability needs to be
investigated and more reliable tests need to be designed, to provide robust and less noisy
test results, to reliably investigate prosopagnosia and its impairments.

3.4. Comparing the other-race effect and prosopagnosia

Face recognition is a robust ability, yet it can be affected by different causes.


Prosopagnosia and the other-race effect are both characterized by impaired face
recognition, and share apparent commonalities. For both groups, holistic processing is
reduced compared to controls (Avidan et al., 2011; Rhodes et al., 1989; Michel et al.,
2006b), as are featural and configural processing (Lobmaier et al., 2010; Hayward et al.,

11
Thesis overview and discussion

2008). Therefore, the other-race effect is sometimes used as an example to explain the
impairments prosopagnosics experience in everyday life (e.g. Kennerknecht, 2011).

As prosopagnosia and looking at other-race faces both lead to reduced face recognition
performance, the same face recognition mechanisms could be disturbed in both cases,
although through different causes. To investigate this hypothesis, we compared whether
prosopagnosia and the other-race effect impair featural and configural face processing in
a similar way. To that end, we tested German prosopagnosics, Korean participants and
German controls on their holistic, featural and configural processing of Caucasian face
stimuli, as well as object recognition. In the study described in chapter III we report the
performance of these groups on tests 1 (CFMT), 5 (Similarity rating), and 8 (Object and
face test), as listed on page 9.

Based on our results, we could disprove the hypothesis that a common underlying
mechanism is responsible for the impairments observed in prosopagnosia and the other-
race effect. Korean and prosopagnosic participants exhibited different patterns in
impairment of featural and configural processing of Caucasian faces. The sensitivity to
the featural changes was about the same for both groups. The sensitivity to configural
changes however was only impaired for prosopagnosics, while the Koreans were as good
as the German controls. Further, we could show that prosopagnosia has a stronger impact
on face processing than does observing other-race faces, as prosopagnosics were
significantly more impaired in recognition of Caucasian faces than Koreans, who in turn
were significantly more impaired than the German controls.

Additionally, we were able to gain new insight into general face recognition mechanisms.
Our results suggest that sensitivity to features is not crucial for determining face
recognition abilities. This is indicated by the fact that we found no difference between
Koreans and prosopagnosics in their sensitivity to facial features, while prosopagnosics
were more strongly impaired in general face recognition abilities than Koreans. However,
we could substantiate the hypothesis that configural sensitivity relates to face recognition
ability (Freire et al., 2000), because prosopagnosics were more strongly impaired in
general face recognition and configural processing than Koreans.

Overall, this study provided new insights into the face processing disturbances caused by
prosopagnosia and the other-race effect, and into general face processing mechanisms.

12
I. Synopsis

3.5. Galactose uncovers face recognition

So far, only one study reported that a form of medication (administration of oxytocin)
was able to improve face recognition abilities in some but not all participating
prosopagnosics (Bate et al., 2013). Therefore, the discovery by a participant of our
studies, LI, that her face recognition improved due to a change in her diet, led to further
investigations of that case. This case report is described in more detail in chapter IV.

LI had added about 5 gram of galactose to her daily nutrition. The reason for this was
self-medication for her attention deficit hyperactivity disorder (ADHD), and was
unrelated to her face recognition deficits.

Galactose is a simple sugar with natural occurrence, for example as a component of the
milk sugar lactose. Healthy humans synthesize two to ten gram of galactose per day. It
was found that oral intake of galactose prevents cognitive deficits in mice induced with
Alzheimer's disease symptoms (Salkovic-Petrisic et al., 2014). Furthermore, descriptions
of several cases of positive effects of the oral intake of galactose for patients with
Alzheimer's or Parkinson's disease exist (Mosetter, 2008).

LI reported that through galactose not only her face recognition abilities improved, but
that in addition, amongst other things, her mental imagery became more vivid and her
sense of orientation increased. The effects vanished after stopping the intake of galactose.
To investigate the universality of this treatment 16 additional congenital prosopagnosics
were recruited to tests the possible impact of galactose on their condition. None of them
reported any noticeable effects. The single occurrence of a galactose-treatable case of
prosopagnosia might be another indicator of the existence of diverse subgroups.

However, we also completed the following (unpublished) study to investigate the


objective effects of galactose in LI. We conducted a double blind placebo study in two
sessions with existing and newly created tests of face recognition, navigation, and mental
imagery (see Table 1). We provided LI with a set of seven 5-gram-doses of galactose and
another set with doses of placebo (starch). To avoid identification based on looks or taste,
both agents were packed in identical-looking medication capsules by a pharmacy in
Münster. LI was asked to stop her private galactose intake for four weeks before starting
the seven-day 'medication' with the first set of capsules. On the day after the seventh
intake, LI was tested and interviewed in a first session by an experimenter naïve as to the

13
Thesis overview and discussion

treatment used. Then another four weeks without private galactose followed, after which
the same procedure was repeated with the second set of capsules and the second testing
session. For each test, two versions were used with different stimuli for both sessions. In
pilot studies, the stimuli were adjusted so that the tests had a similar degree of difficulty
in both sessions.

We found nearly no significant differences2 between the results of tests performed after
galactose or starch intake (ps > .05 for all but two tests; see Table 1 for details). Several
explanations could account for this lack of an effect. Perhaps our tests were not adequate
to measure the effects of galactose. Alternatively, galactose may have different effects on
subjective and objective performance in face recognition. However, some aspects of the
results hint towards a mishap in the test methodology (e.g. a mix-up of the capsules by the
experimenters or the pharmacy): First, LI reported experiencing the known and expected
effects of galactose in the placebo session (session 2), but not in the galactose session
(session 1, see Table 1). Second, significantly better results were obtained in two of nine
tests in the placebo session, with other tests showing a similar trend. The latter could be
due to training effects, because of the repetition of session 1 tests in session 2.
Alternatively, we cannot exclude the possibilities that the effects of galactose for LI vary
depending on another factor that is yet to be discovered. Overall, the double-blind
experiment unfortunately gave no experimental evidence that corroborates the subjective
effects of galactose on face recognition experienced by LI. Therefore, our initial findings
published as indicated in chapter IV (Esins et al., 2013) should be taken with caution.
Further tests are necessary to verify if galactose has positive effects and can serve as a
possible therapeutic method for prosopagnosia.

2
For each test, we calculated the difference in performance between session 1 and 2 for LI. This
difference was then compared to the performance differences achieved by the participants of the
pilot studies on the respective test items. The Bayesian hypothesis statistical methods used for the
statistical analysis are described in (Crawford et al., 2011) and were conducted with the provided
computer programs downloaded from
http://homepages.abdn.ac.uk/j.crawford/pages/dept/SingleCaseMethodsComputerPrograms.HTM.

14
I. Synopsis

Table 1: Tests and results of the double-blind study to investigate the measurable effects of galactose
Session p-value 2
Test Information about Stimulus examples
1 2 (one-
the test
GALACTOSE PLACEBO tailed)
A Australian Face 78 % 81 % p = .40 Faces of Australian Caucasians
Memory Test correct correct to memorize and recognize
(McKone et al., among distractors
2011)
B Chinese Face 56 % 69 % p = .062 Faces of Chinese Asians to
Memory Test correct correct memorize and recognize
(McKone et al., among distractors
2012)
C1 High imagery 88 % 88 % p = .13 Multiple choice sentences A tractor has the
sentences correct correct which need mental imagery large wheels in front
(adapted from to be answered correctly. / in the back / in
(Eddy and Glass, front and back
1981)) Multiple choice sentences
which need NO mental A week has five / six
C2 Low imagery 75 % 100 % p = .005* imagery to be answered / seven days.
sentences correct correct correctly.
D1 Navigation - 7 7 p = .27 Remember and recall the
Number of correct way through a
wrong turns labyrinth (steering similar to
an ego-shooter computer
D2 Navigation - 81.7 s 73.5 s p = .32 game). Walking time and
Mean walking number of incorrect turns
time through are measured. Same as test
the labyrinth number 5 listed on page 9.
D3 Navigation - 0.14 1.08 p = .086 Recognition of street corners
Scene d' score d' score in a labyrinth after walking
recognition through it
E1 Mental rotation 98 % 98 % p = .21 Mental rotation – recognition
– accuracy correct correct if rotated letters and symbols
are mirror-inverted.
E2 Mental rotation
– reaction time 1.53 s 1.24 s p = .018* Mental rotation – mean
recognition time
F Vividness of 4.85 1.10 - Rating of strength of a The sun is rising
Visual Imagery mental image on a Likert- above the horizon
(Marks, 1973) scale from 1 to 5 (low value = into a hazy sky
high self-reported imagery)
G1 Sensitivity to 0.86 -0.53 Same as test number 5
facial features invalid† listed on page 9 and
described in detail in
G2 Sensitivity to 0.49 -0.23 chapter III
facial invalid† (Esins et al., 2014b)
configuration
H Interview No Strong - Short summary of self- What changes did you
effects effects reported, perceived perceive since the
noticed noticed effects intake of the capsules?
2
Footnote, see previous page.
* Significant p-values are marked with an asterisk.

Results of test G, session 2 are invalid, because the result values are negative. LI reported fatigue and
reluctance to perform this test in the second session, as it is a rather long (45 min) and tiring test.

15
Thesis overview and discussion

3.6. Search for subgroups

As prosopagnosia was stated to be a heterogeneous disorder (Le Grand et al., 2006;


Schweich and Bruyer, 1993), we assembled the extended test battery to investigate the
possibility to detect subgroups based on patterns of impairment in psychophysical tests.
We also found very heterogeneous impairments amongst our prosopagnosics participants
in the single tests, but we were not able to find signs of common patterns. We used
different mathematical approaches including, amongst others, principal component
analyses, various types of cluster analyses and correlation analyses (Esins et al., 2012).
However, we were able to reveal that prosopagnosics' response behavior is very irregular
as shown by the reduced reliability for prosopagnosics in tests of holistic face processing
(section 3.3 and chapter II). This response behavior leads to noisy results, which might
obstruct finding regularities in response patterns, on which the detection of subgroups is
based. Therefore, we suggest that this irregular response behavior is a possible
impediment to detect subgroups using current tests for holistic face recognition.

3.7. General discussion

This thesis investigated different aspects of prosopagnosia to broaden and advance the
understanding of this disorder. We assembled an extended test battery and used it to
examine the impairments caused by prosopagnosia in different face recognition tasks
(chapter II), and to find differences in the underlying causing mechanisms for
prosopagnosia and the other-race effect (chapter III). We also investigated a single case of
prosopagnosia that appeared to be treatable by oral intake of galactose (chapter IV).

The studies also broadened our understanding of face recognition in general. In chapter
III, we show that the face recognition impairments caused by prosopagnosia are different
from the face recognition deficits occurring when looking at other-race faces.
Prosopagnosia does not only have a stronger impact on face recognition in general, but
also on configural processing of faces. More generally, our results implicate that
sensitivity to facial features is not crucial for determining face recognition abilities, while
sensitivity to facial configuration seems to be linked to face recognition abilities.

Furthermore, our studies are the first to report a possible positive effect of galactose on
one case of prosopagnosia, as described in chapter IV. However, as we could not verify
this effect experimentally, this finding needs further confirmation.

16
I. Synopsis

Another new finding, first reported by our study described in chapter II, is the reduced
reliability for prosopagnosic participants in tests of holistic processing of static faces.
Based on our results it is not possible to point out the actual cause for this reduced
reliability. However, we suggest that a possible source is an irregular, changing response
behavior of prosopagnosics within the tests, for example as a result of the usage of
different compensatory strategies or random responses. The fact that prosopagnosics use
strategies has been reported before (Stollhoff, 2010; Duchaine et al., 2003). Our study is
the first to show that there are indeed qualitative differences in test responses for
prosopagnosics and controls. This irregular response behavior of prosopagnosics indicates
that their test results might not reflect their actual abilities but rather the customary usage
of various strategies or random responding. This is an important finding, meaning that
implications drawn upon these results by future and previous studies should be taken with
caution. In the light of the finding of an irregular response behavior by prosopagnosics,
we will now look back at our two other studies. For the study comparing the other-race
effect with prosopagnosia (chapter III), we argue that our conclusions are nevertheless
valid. We based our conclusions partly on the results of the similarity rating (testing
featural and configural processing; test 5 listed on page 9 and described in detail in
chapter III). This test was shown to have excellent reliability coefficients for
prosopagnosics and controls (see chapter II, Table 4). For the Koreans of the study in
chapter III, reliability coefficients of the similarity rating were > .94 for Cronbach and
split-half estimates for featural and configural condition. We also based our conclusions
partly on the results of the CFMT, which was found to have a significantly reduced
reliability for prosopagnosics (chapter II). However, we only interpreted the results on a
group-wise level, as we argue that, despite low reliability, the tests are suitable for a
coarse comparison of face processing abilities between groups. Looking back at the
galactose study (chapter IV), the finding of an irregular response behavior in
prosopagnosics provides another possible explanation for the absence of an effect of
galactose in LI's test results. A possible irregular response behavior of LI could have
added noise to the results, thus reducing the chances to find an effect (irrespective of the
possible mishap).

Apart from our studies, the finding of reduced test reliability for prosopagnosic
participants also has several implications for general research on prosopagnosia. The
irregular response behavior could be an explanation for the unsystematic pattern of

17
Outlook

impairments, which we observed in our tests (see section 3.6) and which has previously
led others to the conclusion that prosopagnosia is a very heterogeneous disorder (Le
Grand et al., 2006; Schweich and Bruyer, 1993; Schmalzl et al., 2008a). This
heterogeneity was suggested to be intrinsic to prosopagnosia (Schmalzl et al., 2008a). Our
findings suggest that the irregular response behaviors exhibited by most prosopagnosics
could be another possible cause for the heterogeneity of prosopagnosia. Furthermore, this
response irregularity leads to noisy test results. This in turn could obstruct the search for
subgroups of prosopagnosia that relies on finding regularities in response patterns. We
suggest that it might not be possible to detect subgroups of prosopagnosia with the tests
for holistic face processing developed so far.

4. Outlook

Future research should explore the differences in test reliability for prosopagnosic and
control participants and their causes in further detail. Better tests with higher reliabilities
for prosopagnosics need to be designed. In addition, larger sample sizes will be needed
for further investigations of prosopagnosia. Better tests and larger participant groups
could help to increase the signal-to-noise ratio in test results needed for the detection of
subgroups. If subgroups are identified and their respective cause becomes known, it might
even be possible to find specific treatments for subgroups with treatable causes (e.g.
nutritional deficits) to improve the life of the people affected.

18
I. Synopsis

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29
Declaration of Contribution

Declaration of Contribution

This thesis comprises three manuscripts that are either published or prepared for
publication. Details about these manuscripts are presented in the following.

The candidate developed the ideas for the studies, their experimental design and
implementation in collaboration with the supervisors, and recruited participants, collected
and analyzed the data. The co-authors supervised the work of the candidate and assisted
in the revision of the manuscripts.

1. Esins, J., Schultz, J., Stemper C., Kennerknecht, I. & Bülthoff, I. (2015). Face
perception and test reliabilities in congenital prosopagnosia in seven tests. (prepared
for submission): J.E. created the stimuli, programmed the experiment, collected and
analyzed the data. All authors conceived the set-up of the assessment and wrote the
manuscript.

2. Esins, J., Schultz, J., Wallraven, C., & Bülthoff, I. (2014). Do congenital
prosopagnosia and the other-race effect affect the same face recognition
mechanisms? Frontiers in Human Neuroscience, 8(September), 1–14.
doi:10.3389/fnhum.2014.00759; and Esins J, Schultz J, Stemper C, Kennerknecht I,
Wallraven C and Bülthoff I (2015). Corrigendum: Do congenital prosopagnosia and
the other-race effect affect the same face recognition mechanisms?. Front. Hum.
Neurosci. 9:294. doi: 10.3389/fnhum.2015.00294: J.E. created the stimuli,
programmed the experiment, recruited the German control participants, collected
data of Caucasian participants and analyzed the data. C.S and I.K. recruited the
prosopagnisc participants. Recruitment and data collection of the Korean participants
was conducted by Bora Kim, Department of Brain and Cognitive Engineering, Korea
University, Seoul, South Korea. All authors conceived the set-up of the assessment
and wrote the manuscript.

3. Esins, J., Schultz, J., Bülthoff, I., & Kennerknecht, I. (2013). Galactose uncovers
face recognition and mental images in congenital prosopagnosia: The first case
report. Nutritional Neuroscience, 0(0), 1–2. doi:10.1179/1476830513Y.0000000091:

30
I. Synopsis

I.K. was first contacted and informed about the effects of galactose by the
participant. J.E. conducted the interviews with the participant and the assessment of
the influence of galactose on further prosopagnosics. All authors conceived the set-
up of the assessment and wrote the manuscript .

Parts of this work were also presented at the following conferences:

1. Esins, J., Bülthoff, I., & Schultz, J. (2011, May). The role of featural and configural
information for perceived similarity between faces. Poster presented at the 11th
Annual Meeting of the Vision Sciences Society: VSS 2011, Naples, FL, USA.
Journal of Vision, 11(11), 673-673, doi:10.1167/11.11.673.

2. Esins, J., Schultz, J., Kim, B., Wallraven, C., & Bülthoff, I. (2012). Comparing the
other-race-effect and congenital prosopagnosia using a three-experiment test battery.
Poster presented at the Asia-Pacific Conference on Vision 2012: APCV 2012,
Incheon, South Korea. i-Perception, 3(9), 688-688.

3. Kim, B., Esins, J., Schultz, J., Bülthoff, I., & Wallraven, C. (2012). Mapping the
other-race-effect in face recognition using a three-experiment test battery. Poster
presented by B.K. at the Asia-Pacific Conference on Vision 2012: APCV 2012,
Incheon, South Korea. i-Perception, 3(9), 711-711.

4. Esins, J., Bülthoff, I., Kennerknecht, I., & Schultz, J. (2012). Can a test battery reveal
subgroups in congenital prosopagnosia? Poster presented at the 35th European
Conference on Visual Perception: ECVP 2012, Alghero, Italy. Perception,
Vol. 41, 113-113.

5. Esins, J., Bülthoff, I., & Schultz, J. (2014). Motion does not improve face
recognition accuracy in congenital prosopagnosia. Poster presented at the 14th
Annual Meeting of the Vision Sciences Society: VSS 2014, Naples, FL, USA.
Journal of Vision, 14(10), 1436-1436, doi:10.1167/14.10.1436.

31
32
II. Face perception and test reliabilities

II. Face perception and test reliabilities in congenital


prosopagnosia in seven tests

1. Abstract

Congenital prosopagnosia, the innate impairment in recognizing faces, is a very


heterogeneous disorder with different forms of manifestation. To investigate the nature of
prosopagnosia in more detail, we tested 16 prosopagnosics and 21 matched controls with
an extended test battery, addressing various aspects of face recognition. Our results show
that on a group-wise level prosopagnosics showed significant impairments in several face
recognition tasks: they showed impaired holistic processing (amongst others tested with
the Cambridge Famous Face Test (CFMT)), as well as impaired processing of configural
information of faces. While controls showed an improvement of face recognition
accuracy for moving compared to static faces, prosopagnosics did not show this effect.
Furthermore, prosopagnosics showed a significantly impaired gender recognition. There
was no difference between groups in the automatic extraction of face identity
information, or in object recognition as tested with the Cambridge Car Memory Test.

In addition, a methodological analysis of the tests revealed reduced internal consistency


reliability for holistic face processing tests in prosopagnosics. In particular,
prosopagnosics showed a significantly reduced reliability coefficient (Cronbach's alpha)
in the CFMT compared to the controls. We suggest that feature-based response strategies,
employed by the prosopagnosics, might cause a heterogeneous response pattern, which is
revealed by the reduced test reliability. This finding raises the question whether classical
face tests measure the same perceptual processes in controls and prosopagnosics.

33
Introduction

2. Introduction

Congenital prosopagnosia refers to the lifelong, innate impairment in identifying someone


by his or her face (Bodamer, 1947). It is estimated to affect about 2.5% of the population
(Kennerknecht et al., 2006), and is characterized as a neurodevelopmental disorder of
face recognition without any deficits in low-level vision or intelligence (Behrmann and
Avidan, 2005). Not only face identification was found to be impaired in congenital
prosopagnosia, but also other aspects of face processing. However, psychophysical
studies differ in their findings. For example, some studies found impaired gender
recognition in congenital prosopagnosics (Duchaine and Nakayama, 2006a; Ariel and
Sadeh, 1996), while others reported gender recognition to be normal (Chatterjee and
Nakayama, 2012). The same is true for sensitivity to featural and configural facial
information, for which no uniform pattern of impairments was found (Yovel and
Duchaine, 2006; Le Grand et al., 2006). There is also disagreement over holistic
processing. While Avidan and colleagues found evidence for weaker holistic processing
when testing 14 prosopagnosics (Avidan et al., 2011), Le Grand and colleagues reported
that only one of their eight prosopagnosic participants showed reduced holistic processing
(Le Grand et al., 2006). In short, the picture of a very heterogeneous disorder emerges
from these equivocal results (Schweich and Bruyer, 1993; Le Grand et al., 2006), even
when accounting for the differences in experiment and stimulus design.

For these reasons, we tested face perception in congenital prosopagnosia with a rather
large sample of prosopagnosics (16) in more detail. We included two widely used tests
for reference, the Cambridge Face Memory test (CFMT, Duchaine and Nakayama,
2006b) and the Cambridge Car Memory Test (CCMT, Dennett et al., 2011). We also used
test paradigms for which some controversial results exist in literature, and we developed
new tests to investigate perceptual processes in congenital prosopagnosia in more depth.

In the present study, we report and compare the performance of a group of 16 congenital
prosopagnosics to the performance of 21 matched controls in seven tests. We tested
holistic face processing, configural and featural face processing, processing of faces in
motion, unconscious processing of faces, face gender recognition, and object recognition.
For each test separately, we will present motivation, methodological details, results and
discussion. In addition, we calculated test reliabilities for each participant group, which
will be discussed in a separate section, followed by the general discussion.

34
II. Face perception and test reliabilities

3. General methods

3.1. Procedure

The experiments were conducted in two sessions lying about two years apart: on average
24.6 months (SD = 2.3) for prosopagnosics and 20.3 months (SD = 1.6) for controls.
During the first session, participants performed the Cambridge Face Memory Test
(CFMT), a surprise recognition test and a similarity rating test. The second session
included the Cambridge Car Memory Test (CCMT), a facial motion advantage test, the
composite face test, and a gender recognition test. In both sessions, participants could
take self-paced breaks between the experiments.

All participants were tested individually. The experiments were run on a desktop PC with
24" screen. The CFMT and CCMT are Java-script based; the other experiments were run
with Matlab2011b (The MathWorks Inc.) and Psychtoolbox (Brainard, 1997; Kleiner et
al., 2007). Participants were seated at a viewing distance of approximately 60 cm from
the screen. The procedure was approved by the local ethics committee.

3.2. Participants

We tested 16 congenital prosopagnosic participants (from now on referred to as


“prosopagnosics") and 21 control participants (“controls”). All participants provided
informed consent. All participants had normal or corrected-to-normal visual acuity.

Prosopagnosics
The prosopagnosics were diagnosed by the Institut für Humangenetik, Westfälische-
Wilhelms-Universität, Münster, Germany, based on a screening questionnaire and a
diagnostic semi-structured interview (Stollhoff et al., 2011). All prosopagnosics were
tested at the Max Planck Institute for Biological Cybernetics in Tübingen, Germany, and
compensated with 8 Euro per hour plus travel expenses.

35
General methods

Controls
All controls were tested at the Max Planck Institute for Biological Cybernetics in
Tübingen, Germany, and compensated with 8 Euro per hour. Controls were chosen to fit
as closely as possible the prosopagnosic participants in terms of age, sex and schooling
level. Due to time constraints, the controls did not participate in the diagnostic interview
but reported to have no problems in recognizing faces of their friends and family
members.

Table 1: Participants' demographics


Prosopagnosics Controls
Sex Age Sex Age
1 f 22 f 21
2 f 24 f 24
3 f 27 f 24
4 f 28 f 28
5 m 33 f 29
6 m 34 f 31
7 f 36 m 33
8 m 36 m 36
9 m 37 m 37
10 f 41 f 37
11 f 46 m 38
12 m 47 m 39
13 m 52 m 39
14 f 54 f 42
15 m 57 m 44
16 m 59 f 44
17 f 47
18 m 48
19 f 49
20 f 58
21 m 60
♂ 8 9
Mean age 39.6 38.5
Age (in years) and gender ("m" = male, "f" = female)
of prosopagnosic and control participants

To provide an objective measure of face processing abilities and to maintain


comparability with other studies, we tested all participants with the Cambridge Face
Memory Test (CFMT). The z-scores are given in Table 2 for prosopagnosics and Table 3

36
Another random document with
no related content on Scribd:
“Of course you’re right, Madeline,” Betty assured her, stirring her tea
absently and forgetting to eat any of her muffin. “I detest people
who can’t get along alone. It’s silly to try to do a lot more than you
can, and then expect somebody to come along and take it off your
hands. I hope I’m not that kind.” Betty dropped her spoon with a
clatter, and, sitting up very straight, faced the table with a tragic look
in her eyes and a desperate, determined set to her soft red lips.
“Girls,” she began, with a sudden change of tone that matched her
changed expression, “can you remember solid geometry? I can’t. I
never did know anything about Latin prose, so there’s no reason why
I should now. But not knowing the geometry worries me. I think it’s
getting on my nerves. And then,” she went on, as the little circle only
stared at her in curious silence, “Marie’s lit. notes are just a mess.
Mine were too, and anyhow I’ve lost my note-book. Is yours here,
Helen? Could I take it, and Christy’s? I’m sure I could manage if I
had a decent note-book or two.”
“Speaking of clear and lucid explanations——” began Madeline
slowly. Then she reached across the table to hug Betty comfortingly.
“You shall have all the decent note-books in 19—, if you want them,
you poor thing. And I’m truly sorry that mine isn’t one of them. As
for solid geometry, I’ll wager that not a person in this crowd could
demonstrate—is that the right word for it?—a single proposition. And
as for Latin prose, it’s a gift from the gods. You can’t learn it. Even
Professor Owen, who is a genius, can’t teach it. So stop worrying
here and now, and eat that muffin before somebody is tempted
beyond what she can bear, and a theft is committed in our midst.”
“Is all this trouble caused by Montana Marie O’Toole?” inquired
Christy practically.
Betty nodded, being too busy with the muffin to speak.
“Then,” Mary announced with decision, “what she needs is three
regular graduate tutors, who specialize in lit., math., and Latin prose,
and who will come to her rescue at any hour or hours of the day or
night, at about one-fifty per.”
Betty swallowed a mouthful hastily, to say, “They wouldn’t help her
any, Mary. They’d give up in despair after about one lesson. She’s
not stupid exactly, but she’s poorly prepared, and her mind is—well,
queer. Besides, I promised President Wallace. I agreed to ‘undertake’
her, as Mrs. O’Toole calls it, before he agreed to let her enter with so
many conditions. She’s going to be positively broken-hearted if she
fails at mid-years, and I think”—Betty hesitated—“I don’t think
President Wallace will ever have any use for me again if she does.
And I am busy with other things, and I never did know Latin prose,
and—I’m about in despair.” Betty paused abruptly and attacked the
remains of the muffin as if the eating of it would work a magic cure
of all her woes.
“Betty,” asked Rachel after a minute, “does this freshman try? Does
she want to get through enough to work for it?”
“She doesn’t know how to really work, Rachel, but she tries as hard
as she can. She is awfully sweet and awfully sorry about making
extra trouble. And of course you all understand,” Betty blushed a
little, “that I’m being paid—altogether too much, I thought when
they offered it—for looking after her.” Betty laughed suddenly. “Did
you hear about her Mountain Day exploit? I had to speak to her
about that, of course, to tell her that she mustn’t wear a magenta
handkerchief, and shout so loud on the public highway, and
otherwise make herself too conspicuous. And instead of being huffy,
she thanked me and sent me violets. Oh, she’s a dear! She’s worth a
lot of trouble, only I’m not bright enough to tutor her, and the
regular ones would be sure to get provoked or discouraged at her
queer ways, and just consider her hopeless, and let her drift along,
and finally be flunked out at mid-years.”
“She ought to be flunked out, oughtn’t she?” inquired Helen Adams
acutely. “I mean, she probably can’t ever keep her work up to the
required standard without a lot of help.”
Betty admitted sadly that she never could. “But she needs the life
here, Helen, almost more than any girl who ever came to Harding.
And if I can help her to have a year or two of it, I shall,—as long as
she keeps on trying to do her part.”
“Oh, yes, of course,” agreed Helen uncertainly.
“Is she in your freshman division, Helen?” demanded Mary Brooks,
after a whispered conference with Babbie. “I judged not. Very well
then. You are hereby elected to coach her in lit. No rule against a
faculty’s doing a little friendly tutoring, is there? My husband hasn’t
condescended to bother with any since he got to be head of his
department, but before that——” Mary finished the explanation with
a wave of her hand. “In the theme-work that goes with lit., Madeline
is hereby elected to come to the front. Madeline, I presume you
forgot, when you were talking about solid geometry, that our clever
little Christy here has given up her faculty job to take a Ph. D. in
math. She is hereby elected to assist Miss O’Toole to the
comprehension of sines and co-sines, and so forth—or do sines and
co-sines belong to trig.? And for Latin prose,” Mary’s beamish smile
broke out radiantly, “of course you don’t know it, because it
happened before your day, but Latin prose happens to be the one
useful thing I ever learned. I say useful, because after all these
years, I can use my one small scholarly accomplishment. Oh, I’ve
kept it up! George Garrison Hinsdale has seen to that. Whenever he
seems to be getting a bit tired of my frivolous appearance and
conversation, I read him a little out of Horace or Juvenal or Cicero’s
letters, and he’s so proud of me that I wish I had more scholarly
accomplishments. Only,”—Mary smiled serenely,—“he says he likes
me just as I am. And so, being the Perfect Wife, I will now turn into
the Perfect Tutor, and get Marie Montana O’Toole through her Latin
prose.”
“The business of this meeting having been disposed of,” Madeline
took up the tale, “I hereby demand that we begin to celebrate in
honor of me and my forthcoming novel.”
“And to discuss wedding dates,” added Babbie, “in honor of me and
my Young-Man-Over-the-Fence.”
“Don’t you think,” suggested Rachel, “that first we’d better let Betty,
who has just said she prefers to manage her own affairs, say what
she wants to do about Mary’s elections?”
“When you are elected——” began Mary, but Helen, Rachel, and
Christy, the serious members, silenced her.
“Now, Betty,” ordered Rachel. Betty looked solemnly from Helen to
Christy, from Christy to Madeline, and finally at Mary.
“Would you really do it, girls?” she asked at last.
“Of course,” said Helen quietly.
“You can count on me, if you want me,” Christy told her.
“I can’t promise till I’ve looked over the freshman,” Madeline
qualified. “If she is anywhere near as interesting as she sounds, I’ll
‘undertake’ her theme-work with much pleasure.”
“I’m simply dying to display my one accomplishment,” Mary declared
feelingly.
Betty gave a long, happy sigh. “Then of course I want you all to
help,” she said. “I was just about in despair when I came rushing
down here. And now—you’re not regular tutors. You understand
things. You know how I feel—and how Prexy feels. I couldn’t explain
to a regular tutor that for some unknown reason Prexy cares a lot
about Marie’s passing her exams. And I couldn’t tell them why she
herself needs so much to stay on here. But you’ll see it all. Oh, dear!
I’m so happy!” Betty crunched one of Cousin Kate’s cookies, and
smiled radiantly at Mary, who had “elected” everything so beautifully.
“Well,” inquired Babbie, after a polite interval, “now can we begin to
celebrate and plan weddings?”
“Easily,” Mary Brooks assured her. “Only don’t forget, all of you,
whether you have been elected tutors yet or whether you haven’t,
that you’ve each and all got to help. The B. C. A.’s have adopted a
new object—we have undertaken Montana Marie O’Toole—and it
may need our entire combined effort to make her a credit to us and
to Harding. But we’ve got to do it. And do it we will!”
“Hear! Hear!” from Madeline.
“The B. C. A.’s to the Rescue!” cried Helen.
“Betty Wales and her freshman!” added Christy.
They drank the toasts with much enthusiasm in fresh cups of tea—
poured out without the use of a strainer, because the next “feature”
on the program was to be tea-ground fortunes all around, read by
that past-mistress of the fine art of making everything interesting,
Miss Madeline Ayres.
CHAPTER VI
THE INTERVENTION OF JIM

Montana Marie O’Toole accepted with her accustomed submissive


sweetness the new tutors “elected” to office by Mary Brooks
Hinsdale and tactfully introduced to their victim by Betty Wales, who
explained just why she had consented to a division of labor.
“They do seem to make me understand better,” Marie told Betty, a
few days after the beginning of the new régime. “That Miss Mason is
awfully smart, isn’t she? But fortunately she isn’t anything like that
smart tutor I had last summer. Miss Mason makes me puzzle things
out for myself. It takes a lot of her valuable time, I’m afraid.” Poor
Marie sighed deeply. “It’s a great responsibility, wasting the time of a
faculty and a—what’s that Miss Mason is?—oh, yes, a Fellow in
Mathematics. And I can’t pay Miss Adams, because it is against the
rules for the faculty to be paid for tutoring. Is it against the rules for
me to send her flowers every day, Miss Wales?”
Betty remembered how violets used to make Helen’s eyes shine, and
said no. “Only you mustn’t be extravagant, you know. Every day is
much too often to send flowers.”
“I can’t say that I think it’s any too often to get flowers,” smiled
Montana Marie. “And so far Pa hasn’t objected to any of my bills. It’s
fortunate, isn’t it, that my father isn’t as poor as I am stupid?”
“You’re not stupid,” Betty encouraged her. “If you’ll only keep on
trying——”
“Oh, I shall keep trying.” Montana Marie was firm as a rock on that
point. “I’ve inherited my father’s stick-to-itiveness, if I haven’t
inherited his brains. Now I might have been a flyaway like Ma. And
in that case things would have been pretty hopeless, wouldn’t they,
Miss Wales?”
Two days later Montana Marie appeared at Betty’s office, the fire of
determination in her lovely eyes.
“I saw a sign on the bulletin-board that said there was an
unexpected vacancy in Morton Hall. Is that so?”
Betty nodded abstractedly, her finger on the place where she had
left off reading a letter from Mr. Morton.
“Then I want to fill it. I’ve got to leave the Vincent Arms because it’s
too diverting to my mind. If I could live in the dormitory with you, I
should be made!”
“But Morton Hall is a special dormitory,” Betty explained patiently, as
she had many times before, to admirers who had thought it would
be the making of them to live in “her dormitory.” “And you’re not
eligible.” She went into details. “So you can’t possibly come, and if
you could I don’t think you’d like it. The harder a person works the
more she needs recreation. But most of my girls have had too much
work and too little play all their lives long. They don’t know how to
play the way Georgia Ames and Miss Hart and the Duttons do. You’d
find them dull after the others.”
“Then in that case my mind would stay right on my work. I’m just
the opposite from them, Miss Wales. I’ve had too much play and too
little work all my life until now. They say opposites attract, so I’m
sure I should get along splendidly with those girls.”
“But you’re not eligible,” Betty repeated.
Montana Marie considered that. “Suppose no poor girl wants to
come in just at present,” she suggested at last. “Moving in the
middle of the term is a bother, isn’t it? Don’t most girls promise to
keep their rooms right through the term or even for the whole year?
Couldn’t I have the room as long as it is empty,—just until some
eligible girl wants it?”
Montana Marie didn’t mind moving in, with the strong probability of
having to move out again very soon; she had lived in trunks and
hotels most of her life, and was used to picking up at a moment’s
notice whenever her flyaway mother got tired of eating Swiss honey,
or buying Dutch silver, or studying German art, and decided to move
on.
The vacant room that Betty had advertised on the bulletin-board was
a third floor single, but when the Thorn, who shared one of Morton
Hall’s few doubles, begged quite pathetically for a chance to room
alone, Betty had not the heart to refuse her. Secretly, too, she was
relieved at the prospect of thus finally settling the question of
Montana Marie’s coming into the house; for in spite of her protégée’s
excellent logic, Betty doubted the wisdom of mixing such alien
elements as Montana Marie and the Morton Hall girls, and if anybody
suffered from the situation she felt sure it would not be the
exuberant Montana Marie, with a mind of her own and a genius for
getting what she wanted. Still Marie had been thoroughly in earnest
in wanting to find a boarding place where she could study without
interruption. Betty broke the news to her gently.
“Matilda Thorn’s—I mean Matilda Jones’s roommate,” she explained,
“is a funny little junior from Corey Corners, New Hampshire. She
taught a district school for two years, to earn money enough to
justify her in beginning her college course. In the summers she is
waitress in one of the big White Mountain hotels, not far from where
she lives, and she usually earns a little extra by taking care of some
rich woman’s children when their nurse wants a holiday or an
evening off.”
Montana Marie listened intently. “She must know how to concentrate
her mind, if she does all that. I should think she’d be an ideal
roommate for me, shouldn’t you, Miss Wales? But maybe she won’t
like me. Could you arrange to have us meet, Miss Wales, and then
you could ask her to say honestly what she thought, and if she
didn’t object to me I could move in right away.”
Montana Marie’s calm determination to look on the bright side of
things took the wind out of Betty’s opposition, just as, a little later,
her radiant, magnetic charm won from the rather washed-out,
nervous junior from Corey Corners an eager assent to Betty’s
proposal. Montana Marie, five trunks, a Mexican saddle and a striped
Parisian hat-box containing a hat that was too big for any
compartment in the pigskin hat trunk, appeared without loss of time
at Morton Hall. Being systematic, Montana Marie immediately set to
work at disposing of her possessions within the limited area of half a
rather small room and half a very small closet. After an hour’s work
and ten minutes’ thoughtful contemplation, she invited her new
roommate, who was trying to write an argument paper, to go down-
town and help find a carpenter. The roommate compromised by
telling Marie where the best carpenter in Harding was to be found,
and Marie went off happily. A minute later she reappeared with a
question.
“I’m going to have him make me a box to go under my bed. Do you
keep things under your bed? You don’t? Then do you mind if I have
him make two boxes? I have such a silly lot of clothes. Oh, thank
you so much. You’re the nicest roommate! Sure there are no errands
I can do for you?”
Without looking up from her work, the strenuous little junior said no
to that, for at least the third time; but when Marie presented her
with a box of chocolates, evidently as a reward for being obliging
about the bed-box, she relaxed her Spartan discipline and ate so
much candy that she had indigestion, and was compelled to finish
her argument paper in a style far inferior to that in which she had
begun it. This adventure made her wary, and however easily the rest
of Morton Hall fell into Montana Marie’s enticing snares, her
roommate kept aloof. Her name was Cordelia Payson, but Montana
Marie always referred to her by Fluffy Dutton’s title, “The
Concentrating Influence,” which Straight Dutton shortened, for her
own and others’ convenience, to “Connie.”
The carpenter recommended by “Connie” duly produced two bed-
boxes, after Montana Marie’s design, which included castors, brass
handles for pulling them out and lifting the covers, and interior
upholstery of pale blue satin, violet-scented. When they were
delivered, Montana Marie again attacked the problem of emptying
the five trunks which had effectively blocked the hallway since her
arrival. When she had done her best with the bed-boxes, there was
still a trunkful of dresses to dispose of. Montana Marie again spent
ten minutes in contemplation, and then sallied forth to order a closet
pole arranged on a pulley, and equipped with two dozen dress-
hangers.
“I’ll keep it up in that waste space under the ceiling,” she explained
to the Concentrating Influence. “I’ll hang my evening dresses on it,
and things I don’t like and seldom wear. When I want to let it down,
it won’t kill me to empty out part of the closet on to some chairs.
Otherwise,”—Montana Marie surveyed the tightly wedged mass of
clothes cheerfully,—“otherwise I’m afraid it wouldn’t plough through
that mass and drop down. I’ve got too many things, that’s evident.
When mid-years are over and I have a little time to turn around in,
I’ll sort them out and get rid of all but what I strictly need. And
then,” she giggled cheerfully, “it will be time to get a lot of new
clothes for spring. I love spring clothes, don’t you?”
“I’ve got to finish reading this book to-night,” the Concentrating
Influence told her primly, planting her elbows on her desk, and
stuffing her fingers into her ears.
“Oh, excuse me,” begged Montana Marie contritely. “I’m a dreadful
bother. I talk too much. When you finish the book, could you show
me a little about these originals that come after the twenty-sixth
proposition?”
The Concentrating Influence had not forgotten her solid geometry.
With casual assistance from her, and the definite and determined
help of Mary Brooks Hinsdale and her corps of selected tutors,
Montana Marie was making some slight progress. Betty’s part was to
keep Marie fully impressed with the slightness of the progress and
the need for keeping up all of her work instead of letting part slide
while she devoted herself to the mastery of one particularly
troublesome subject; also to preach her tactful little sermons about
the rights of roommates who were too obliging to object to being
imposed upon. After one of these lectures Montana Marie always
presented the Concentrating Influence with candy or flowers in
absurdly generous quantities.
But it was not the candy and flowers that made the junior from
Corey Corners feel as if, after having “scraped along” for years, she
had suddenly begun to live. It was Montana Marie’s unconscious
assumption that she, Cordelia Payson, was a wonderful person, that
all Harding College thought so, that girls like Georgia Ames and the
Duttons and even that snobbish Eugenia Ford had noticed how well
she did in argument, had been sorry she didn’t “make” the class
hockey team, and had wished they knew her better.
Montana Marie could not help saying pleasant things; she had been
educated to do so. She could not help admiring mental
concentration; Betty Wales had talked nothing else to her all the
year and “Connie” illustrated all Betty’s points as perfectly as if she
had been created for no other purpose.
So it was small credit to Montana Marie that she made Cordelia
Payson happy. Neither was it at all to her credit that she was
instrumental in bringing Jim Watson hot-foot to Harding to
investigate the supposedly prevailing dissatisfaction with Morton
Hall, and incidentally to give the overworked Betty Wales two
splendid, all-the-afternoon rides, and, in addition, the restful feeling
that she was being looked after by a resourceful and a resolute
young man.
It all came about in this way. One day when Marie had finished a
Latin lesson with Mrs. Hinsdale, that lady walked back to the campus
with her pupil on the way to a reception in town. Mary inquired
solicitously for Betty, whom she had not seen for several days.
“She’s all right, I guess,” explained Marie easily. “Only she’s sort of
absent-minded, and I notice that she doesn’t eat much.”
“She’s overdoing dreadfully,” sighed Mary.
Montana Marie considered. “As far as I have noticed I should say
that a person feels better for working hard. Ma does nothing, and Pa
never takes a vacation, and he’s a lot stronger than Ma is, and
happier. But work is one thing, and worry is another,” sighed Marie.
“Worrying uses a person up like anything. Maybe Miss Wales has
something on her mind. Who is this Mr. Jim Watson that you all
tease her about, Mrs. Hinsdale?”
Mary explained, with a dignity that was quite lost on Montana Marie,
about Jim and Eleanor, Jim and Morton Hall, and Jim and Betty.
“Wonder if she’d like to see him,” speculated Marie. “She seemed
awfully cheerful when I saw her in the summer, right after he’d been
in Cleveland. For my part I should certainly like to see him.” Marie
sighed again. “I get so sick of having no men to talk to—not even
faculty men. Every single one of my divisions recites to a woman.”
That night Montana Marie let her mind wander shamefully from
math., lit., and Latin prose. At last her contemplative smile flashed
out into sudden, mischievous brilliancy. Selecting a sheet of her best
lavender-tinted, violet-scented note-paper, she covered it rapidly
with her sprawling, unformed characters, and directed it to Mr.
James Watson, in care of his firm, the name of which she had
fortunately remembered from Mary’s recital.
Two days later Jim Watson, grinning sheepishly, stuck his head, in
his accustomed furtive fashion, in at Betty’s office door. Finding only
one small person, with curls and a dimple, in the office, Jim came in
a little further, and stood awaiting developments, grinning now much
more cheerfully.
“What in the world are you doing here?” demanded Betty
breathlessly, jumping up to shake hands.
Jim strolled over to the desk. “Don’t get up.” He sat down solemnly
in the visitors’ chair. “Don’t you really know why I’m here?”
“No-o,” gasped Betty, dreadfully afraid of what might be coming
next. “But I know something else. You ought to be hard at work in
New York.”
“I have come,” Jim began very solemnly, “to investigate serious
charges brought against the efficiency of the architects, particularly
the resident architect-in-charge, of Morton Hall. My first duty is
naturally to ascertain whether you are personally convinced of the
truth of said charges. We aim to please.” Jim grinned again.
“Particularly, to please one small secretary, with curls and a dimple,
and a lot too much to do.”
Betty leaned back in her big chair and wrinkled her face into a
delightful, childlike, all-over smile. “Please explain, Jim. It’s mean to
tease a person like me that can’t ever see through it.”
Jim frowned, a portentous, businesslike frown. “Haven’t I made
myself clear, Miss Secretary?” He fumbled in his pockets, and
produced with a flourish Montana Marie’s lavender-tinted, violet-
scented, scrawling note. “I got this communication yesterday, and I
came right up to see about it.” He handed the note to Betty.
“Mr. James Watson,
“Dear Sir:
“You didn’t do a very good job on Morton Hall. There is a
lot of waste space under the ceilings of the closets. They
are also too small. So are the double rooms. The halls are
too narrow when there are trunks around. I have fixed my
closet. I think it would help you in your work to see how I
did it.
“Miss Wales, whom I believe you know, acts rather tired
these days.
“Yours respectfully,
“Marie O’Toole,
“A Morton Hallite.”
Betty puzzled out Marie’s hieroglyphics slowly, read the note through
again, and sighed despairingly, “What will that girl do next?” Then
she laughed till the tears came. Then she turned severely upon Jim.
“You could see that it was all nonsense. Why in the world did you
bother to come rushing up here on account of a piece of foolishness
like that?”
Jim only grinned. “I wanted to meet Miss Marie O’Toole of Morton
Hall,” he announced calmly. “Have you any objections?” Then he
went on, in a different tone, “I say, Betty, be a good fellow, and let’s
go riding after lunch. I’m feeling a bit stale,—honestly I am. An
office-man like me ought never to have been brought up on ranches.
If I hadn’t acquired the fresh-air-and-exercise habit when I was a
kid, I might be able to make a reputation now. But I can’t stick to a
desk long enough.”
“Miss O’Toole will ride with you, poor tired man,” laughed Betty. “She
comes from the West, too, and she rides like an Amazon, so she’ll
give you all the exercise you want, trying to keep up with her.”
“Thanks,” said Jim briefly. “I prefer you. Say yes, Betty, like a lady,
and I’ll clear right out and let you do a morning’s work in peace.”
Betty hesitated and was lost.
“At two then,” Jim sang back gaily as he “cleared out.”
“I’VE PASSED OFF MY ENTRANCE LATIN”
Five minutes later Montana Marie appeared in Betty’s office looking
particularly radiant. “I just stopped in to tell you that I’ve passed off
my entrance Latin,” she said. “I knew you’d be glad——” Her eyes
fell on the lavender-tinted note, which Jim had forgotten to recover,
and she flushed guiltily.
“You shouldn’t have done such a thing,” Betty told her severely, as
her glance followed Marie’s. “Mr. Watson has just been here. He
thought—he wanted——” Betty stopped short, and her merry
laughter rang out so loud that the psychology class, which was
reciting next door, heard it and wondered.
“Mr. Watson will be at the Morton for dinner to-night,” Betty began
again, smiling this time, “so be sure not to go out anywhere,
because I shall need you to help entertain him.”
“I guess you don’t need me,” beamed Montana Marie. “I rather
guess not! But I’ll be there. You can count on that, Miss Wales. I—
I’m sorry if I’ve bothered you, but——” Marie stopped and slipped
softly out, for Betty was not listening. With a shining, far-away look
in her eyes, and a smile on her lips, she was thinking of—something
else.
“I’m not sorry,—not a bit sorry,” murmured Montana Marie, hurrying
off to her next class. She did not refer to the fact that, by delaying
too long in Betty’s office, she had made herself late again—the
second time that week—for freshman math.
CHAPTER VII
BINKS AMES MAKES A DISCOVERY

“Binks” Ames, otherwise Elizabeth B. Browning Ames and first cousin


to Georgia, was now a sophomore. Being a strenuous little person
and addicted to walks in all weather, she had grown even thinner
and browner than she had been as a freshman. When she timidly
discovered a friend in a crowd of girls she did not know and flashed
her a friendly greeting, Binks seemed to be all wonderful big gray
eyes and wonderful sweet sympathy.
“Binks is peculiar,” Georgia explained her tersely. “Couldn’t help that,
could she, with a mother who goes in for Browning and Municipal
Improvement and Suffrage and the Uplifting of the Drama and all
such nonsense? Binks is lovely to her—pretends to take an interest
in all her isms, and bluffs about understanding Robert Browning and
Henry James, and about liking her name. But it’s all bluff. Binks is
just as sensible as I am, and lots and lots more—decent,” ended the
unsentimental Georgia. “Takes home stray cats, you know, and goes
walking with freaks,—and doesn’t mind the bother. I never in all my
life set eyes on as many stray cats as Binks finds homes for in a
good average week. Of course Esther Bond is her big discovery. She
was responsible for getting Esther into the Morton, you know, and
since then Esther has mysteriously developed into the biggest all-
around Senior Star that we’ve got.”
“Really?” asked Straight. “That queer Miss Bond?”
Georgia nodded solemnly. “Jumped into things like that.” She flashed
out a capable hand. “Argus board, Senior Play Committee, and I
guess Ivy Orator. Of course Helena Mason’s dropping out gave
Esther an extra-good chance to step in, but it’s wonderful all the
same. It must be lots of fun to be a perfectly Dark Horse like her.
People would be so agreeably surprised that they’d appreciate you
even more than you deserve.”
“Instead of wondering how in the world a commonplace girl like
Georgia Ames ever got to be so popular,” mimicked Fluffy, the tease.
“I say, Georgia,” demanded Straight, who liked college because it
offered her the chance of knowing such a variety of people, and so
of satisfying every mood, and developing every trait of her own
complex character. “If you’ve got a cousin as clever as all that, why
don’t you let us meet her? I don’t believe I ever so much as heard of
her before. We ought to be looking up the eligible sophs, you know.
Dramatic Club’s first sophomore election isn’t so very far off. Is
Elizabeth B. B. Ames a possibility?”
Georgia gave a little start of surprise. “Why, I don’t know. Honestly I
never thought of her as one, and yet compared to some girls that
are being rushed and discussed, and to some that are expecting it—
you see, Binks is—well, different. I can’t imagine her in Dramatic
Club. She’s so queer that she might actually refuse to come in.”
“You said she was just as sensible as you are, Georgia,” Fluffy
reminded her. “That’s not so much—but at least you didn’t refuse
Dramatic Club.”
“Have a tea-drinking and let us see her,” Straight settled the
controversy briskly. “I for one want to see her. Come along now or
we shall be late for the hockey.”
A few days later Georgia, finding a free half-hour on her hands, went
over to the Westcott House to see Binks. Not having paid much
attention to the college career of her peculiar cousin from Boston,
Georgia was surprised and pleased to find said cousin’s room full of
a departing House Play Committee, who were loud in their praises of
Binks’s ability.
“It’s only that I sew costumes for them,” Binks explained when they
had gone, leaving the room still fairly full of gilt crowns, ermine
robes, and foresters’ doublets and hose of Lincoln green. “I love to
sew, only I don’t know how very well.”
Georgia surveyed her cousin critically. “Should you like to belong to
Dramatic Club?” she asked abruptly.
Binks smoothed out a bit of purple canton flannel that looked exactly
like velvet with loving little pats. “I don’t know. Do you belong? Is it
fun?”
“I belong,” Georgia told her, “and I think it’s fun, but I suppose some
people might not—if they were queer enough in their tastes.”
“It’s nothing like any of Mother’s clubs, is it?” inquired Binks
anxiously. “I don’t care about that kind of fun—writing papers, and
speaking to the legislature about changing laws, and all that.”
“Binks Ames,” began Georgia solemnly, “don’t you honestly know
more than you’re pretending to about Dramatic Club? Because if you
don’t you ought to join for your own good and to learn a little
something about college life.”
Binks smiled vaguely. “I don’t seem to have time to do all the things
you do, Georgia. You see, I have to specialize in economics to please
Mother, and in history to please Father, and in astronomy to please
myself. And then there are so many queer girls that I get mixed up
with, as I did with Esther Bond and Miss Ellison—the poetess person.
She is forever taking me for walks and spouting poems to me all the
way. I tell her that I don’t know anything about poetry, but either
she doesn’t believe me or she can’t find any one else who will
listen.”
“No reason why she should bother you,” grumbled Georgia, who
began to think that Binks might be worth cultivating.
“Oh, yes it is,” Binks told her seriously. “You see, she believes in her
poetry, and I guess it is all right enough. Anyway, if she stopped
believing in it, she would be too discouraged to go on trying to write
it. So if I can keep her going until she’s sure one way or the other,
why, it’s little enough for a general utility person like me to do.”
Georgia sniffed. “I hope some of the numerous geniuses that have
sponged on you will amount to something,—and that some of the
cats you have picked up will take prizes at Cat Shows.”
“But I don’t pick them up because they are nice cats,” objected Binks
solemnly, “only because they are lost, poor things!”
“Don’t forget about having tea with us to-morrow,” said Georgia,
getting ready to leave. Her half-hour was up, and besides, she hated
queer theories.
Binks did not forget to come for tea with Georgia and Georgia’s
friends. She arrived on time, and becomingly dressed. She listened
with gratifying appreciation to the sprightly conversation kept up by
Fluffy and Susanna Hart, with some help from the others. She talked
enough to be agreeable, and not enough to seem overanxious to
make a favorable impression on the leading spirits of Dramatic Club,
who could “make” her career at Harding, if they thought it worth
while to include her in the enchanted company of the sophomores
who “went in” at the first sophomore election.
As a matter of fact Binks did not know that the tea-drinkers all
belonged to Dramatic Club. She did not guess why she had been
asked to the tea-drinking. She had indeed entirely forgotten
Dramatic Club, and had never given a second thought to Georgia’s
question about her wanting to be elected to it.
Georgia, being a close observer, saw all this, and made up her mind
to work hard for Binks’s election. Her little cousin’s extreme
unworldliness made her seem to the straightforward, clear-headed
Georgia a rather pathetic object, to be looked out for and defended,
and secured the rights and privileges that she herself did not know
enough to demand. And, as what Georgia said always “went” with
her large and very influential circle of friends, Binks was promptly
slated as one of the fortunate sophomores whom Dramatic Club was
to single out as those most wanted in its councils.
While this was being decided casually on the way up the Belden
House stairs, Binks was sitting alone in her little room, staring out
with troubled eyes at a lovely wind-tossed sunset.
“Shouldn’t have said I’d do it, I suppose,” murmured poor Binks.
“Only I hate to say no. Georgia would call me a silly! Wish I’d told
Georgia all about it. I didn’t have any chance to talk to her alone.
But I might have made a chance—perhaps. Georgia knows Miss
Wales better, and anyway she doesn’t mind asking people to do
things. Oh—come in!”
The door opened slowly and the poetess, looking tired and out of
temper, came in. “I wanted you to go walking,” she said
reproachfully. “I came at four as usual, and you were out.”
“But yesterday I stayed in for you, and you didn’t come at all,”
explained Binks patiently. “And I left a note on the bulletin-board
about to-day.”
“You know I never look at the bulletin-board,” returned the poetess
sadly.
“But you ought to,” began Binks, and stopped short. “Never mind.
Let’s not bother over what’s past. Do you want to go walking some
more, or would you rather just sit here and watch the sunset?”
Miss Ellison stared gloomily out the window. “I’m too tired to walk
any more. That divan looks awfully comfortable.”
Binks, who was sitting on the divan, stood up politely. “It is. Did you
want to write, perhaps? Because if so, I’ll go away.”
The poetess sank gracefully down among the cushions, pillowing her
cheek in one white hand.
“I’ve put paper out here in plain sight,” Binks told her, “and please
try not to spill the ink. Good-bye.”
“Don’t stay too long,” commanded the poetess dreamily. “I shall
want to read things to you a little later.”
“All right,” Binks promised, and hurried off to find Georgia.
“I want to ask you to do something for me,” she began abruptly.
Georgia frowned at the stupid mistake she had made about Binks’s
unworldliness, and shut the door. “Is it about Dramatic Club?” she
asked. “Because you know, Binks,—or rather I suppose you don’t
know,—that girls are not supposed to ask any member to help them
get in. But I don’t mind telling you that I’ll do my best for you, and I
think all the others will.”
Binks waited patiently for Georgia to finish. “I understand that,
Georgia,” she began. “I mean that I know, even though I am rather
out of things here, that it’s not Harding custom to act as if you
wanted to be in anything. You must just pretend you don’t care. I try
to act that way, but I can’t, about things that I really do want.”
Georgia looked troubled. “But, Binks, it will queer you hopelessly if
you give yourself away about Dramatic Club. Promise me solemnly
that you won’t ask anybody else to help pull you in.”
Binks sighed. “I’ve got to go back in a minute, and I came about
something special. Dramatic Club isn’t a thing I really do want,
Georgia. Why, I don’t know enough about it to think whether I want
it or not. But I’ve discovered something again, and I’m such a ’fraid
cat that I thought maybe you’d tell Miss Wales—that is, if you think
she ought to know.”
Georgia looked hard at her queer little cousin. “Go ahead and tell
me,” she said, after a long stare of amazed incredulity. “Go ahead
and tell me, and I’ll tell Betty, if that’s what you want. But of all
innocent, simple-minded, dense——” Georgia paused. The degree of
Binks’s densely innocent simple-mindedness could not be put into
words.
“Well,” began Binks intently, without noticing Georgia’s muttered
epithets, “you know the way I always get mixed up with freaks—the
way I did last year at the infirmary, with Mariana Ellison, who writes
——”
“I know—the C. P.,” interrupted Georgia hastily.
“C. P.?” repeated Binks questioningly. “Oh, yes, the College Poet.
That’s the one. And Esther Bond was there, and a scientific prod,
named Jones.”
“I know—the one with the comical squint,” put in Georgia, smiling at
the recollection.
“Well, she’s got a sister,” went on Binks quickly, “a freshman. They
thought they had enough money for two, with the junior one’s
scholarship and what she earns tutoring. And then they found they
hadn’t, and the Student’s Aid doesn’t generally help freshmen.” Binks
frowned. “You can’t blame the poor things. The junior got Miss
Wales to give her a loan, and then she passed it over to her sister.
And now after it’s gone and she can’t pay it back, it has worried her
so that she’s about sick, and Dr. Carter wants her to give up tutoring
and get another loan to carry her through the term.
“And she wouldn’t! She came to me and told me and cried, and I
said—well, I suppose I promised to fix it up. Wasn’t that foolish,
when I can’t even explain it to you so that it sounds plausible? Why,
I’ve actually left out both her best excuses for doing what looks so
dishonest! One is that she could honestly say she needed the loan
herself, because she did. She’s gone without enough to eat lots of
times this year. The other is that the freshman is awfully bright and
not very strong, and if her uncle—— Goodness, I forgot to say that
an uncle promised to help the freshman, and then, after she’d given
up her country school and come to Harding, he backed out. Don’t
you think there is a good deal of excuse for her, Georgia? Of course
the freshman isn’t to blame at all, because she didn’t, and doesn’t
know where her sister got the money. There! That’s another point I
forgot to bring in in its proper place.”
“You have got a rather disorderly mind, Binks,” admitted Georgia.
“You’ve entirely left out the point that interests me most of all. Why
did Miss Jones tell you her story?”
“Oh, I don’t know,” returned Binks plaintively. “I never know why
people tell me queer things. Of course you understand that she had
to tell somebody to get it off her mind. And now I’ve got it off my
mind, and I must go right back home. Miss Ellison might be waiting
for me.”
“Let her wait,” advised Georgia coolly. “Did Miss Jones tell you to do
as you thought best with her unpleasant little tale?”
Binks nodded.
“Well, are you sure we hadn’t better just smother it?”
Binks’s small face took on a curiously scornful expression. “Of course
we hadn’t better smother it. She told me, so that I’d tell the right
ones and have it fixed right, so that she can feel honest again. You
see,”—she sighed—“those freaks always think that I will know how
to fix things—and I never do know. But I can find out,” added Binks
serenely. “I’m bright enough to do that. Only it is an unpleasant
story, and you know Miss Wales, and how to tell it to her right. I
think—I’m sure you’d better tell her, Georgia, if you’ll be so kind.”
“Certainly,” said Georgia. “Betty’s undoubtedly the one to handle it.
I’ll see her some time to-morrow.”
“Oh, thank you, Georgia.” Binks glanced anxiously at her watch and
slipped on her ulster. “Perhaps I can do something for you some day.
I do wish I could.”
“Nonsense,” said Georgia bluffly. “I’m not doing anything. Good-bye.”
“Good-bye.” Binks paused uncertainly on the threshold. “I forgot to
say that I don’t think the freshman sister should stay on here, even
if she had the money. I think she is really ill.”
“Dr. Carter thinks so, you mean?” asked Georgia.
“Dr. Carter hasn’t seen her. I think so myself. Mother is great on
germs, you know, and I’ve learned to notice when people look ill.
The freshman sister is pale and thin, and she coughs just a little,
and she works on her nerves—much too hard. She ought to live
outdoors for a while and get rested up and fed up. And if she would
do that, why perhaps Mother would know of a free sanitorium that
takes in—whatever she has. I must go now.”
Little Binks hurried eagerly off to conciliate the impatient poetess,
leaving Georgia to meditate upon her peculiar cousin and the
pathetic story she had told.
“To have people think you’re not honest!” reflected Georgia. “I
remember something about that from my freshman year. It’s pretty
bad. But to know yourself that you haven’t been honest—that must
be just perfectly dreadful. Poor thing! In a way it was all right, too.
That makes it even harder. And it’s abominably hard not to have any
of the things that most girls have here so much too much of. Why,
that squint of hers is enough to make her think crooked, and be
discontented with life! And if the sister is so done up that she has to
leave, then the dishonesty will have been all for nothing. Poor Betty!
She won’t think I’m much of a rescuer when I dump this bundle of
bothers into her nice, comfortable lap.”
CHAPTER VIII
JISTS AND SUFFRAGISTS

“You can get a thing off your mind easily enough by telling it to
somebody,” said little Binks Ames very soberly. “But it isn’t so easy to
get it off your heart. I don’t know how to begin, and I hate to bother
you and Miss Wales any more, Georgia, but something has simply
got to be done for that poor freshman Jones.”
“Didn’t your mother know of any free sanitorium?” demanded
Georgia.
Binks shook her head. “It costs seven dollars a week at the one she
ought to go to, and she’d probably have to stay a year. Seven times
two is fourteen and seven times five is—— Oh, dear, I can’t do it in
my head!”
“Three sixty-four,” computed Georgia rapidly. “More than it would
probably cost her to stay on here for a year. And that was more than
she’s got. Can’t she get well at home?”
“Maybe,” said Binks absently, “but she’s a lot surer to at the
sanitorium. Georgia, you remember the day you asked me for tea at
the Tally-ho? It was full, and everybody seemed to be having a good
deal to eat. Your bill for six—I couldn’t help seeing it—was two
dollars and ten cents.”
“It was,” said Georgia, “and I had to borrow the ten cents of Fluffy
Dutton. Why will you unkindly recall that embarrassing incident,
Binks?”
Binks smiled politely at Georgia’s little joke. “I was just thinking—if
that tea-shop is full every afternoon, and each girl spends thirty or
forty cents for tea and cakes, why, in a week they must pay out
nearly three hundred dollars.”
“Easily,” agreed Georgia. “And incidentally they ruin their digestions
and their appetites for campus dinners, and we have to eat warmed-
up left-overs for next day’s lunch. But Betty Wales and her tea-shop
flourish, and everybody is happy.”
“I was wondering,” went on Binks soberly, “if the girls wouldn’t be
glad to give away more than they do, if they could see that it was
really needed. Forty cents for tea doesn’t mean anything to most of
them. Now wouldn’t they give forty cents each to help Miss Jones
get well?”
Georgia shook her head slowly. “No, because it’s not amusing. Tea
and cakes, ordered off stunty menus, served among the extra-
special features of the Tally-ho, with your little pals beside you, and
a senior you’re crazy about at the next table—that’s forty cents’
worth of fun, or four hundred cents’ worth, if you happen to have it.
But when you’re asked to give away forty cents, it looks as big and
as precious as forty dollars. It seems as if it would buy all the things
you want, and as if, when it was gone, you’d never see another forty
cents as good as that one.”
Georgia paused triumphantly, and Binks sighed acquiescence. “All
right. You know how things are here, Georgia, and I don’t. They
won’t give the money to Miss Jones, but they’d spend it fast enough
at an amusing benefit performance for her. Is that what you mean,
Georgia?”
Georgia smiled pleasantly. “No, I didn’t mean that, but it’s true, now
that you mention it. You’re too rapid for me, Binks. I didn’t know you
were such a rusher. But you go right ahead with your show—that’s
the Harding term for an amusing benefit performance—and I will
stay behind and attend to such practical details as time, place, and
the kind permission of the faculty, also the valued approval and
assistance of Miss B. Wales. Blood will tell, Binks. You’re going into
this thing with all Aunt Caroline’s fine enthusiasm for good works.”
“That freshman Jones is so pathetic,” said Binks simply. “If she was
my sister I presume I should steal, if necessary, to get her what she
needed.”
“Gracious, Binks!” protested Georgia. “You sound like a dangerous
anarchist.”
“Well, fortunately she’s not my sister,” Binks reassured her cousin,
“so I can just help get up a show for her. What kind of a show would
it better be, Georgia?”
Georgia laughed. “You speak as if shows grew on bushes, Binks, and
we could pick off any kind we liked the looks of. Whereas the sad
fact is that we shall have to snatch joyously at any kind we can think
of—if we’re lucky enough to think of a kind.”
“A suffrage bazaar would be rather nice, wouldn’t it?” Binks
suggested casually. “It would be comical all right, if it was anything
like the real ones. Suffragettes are certainly funny, and antis are
even funnier.”
“Sort of a take-off on the strenuous female, you mean?” inquired
Georgia.
Binks nodded. “We could have speeches and a play, if anybody could
write one, or maybe a mock trial, and then everybody could vote on
the suffrage question. Women’s colleges are always voting on
suffrage nowadays. They seem to like it.”
“That’s good, so far,” Georgia agreed approvingly. “Why not satirize a
few other feminine fads while you’re in the business? I can think of a
lovely parody on æsthetic dancing. My mother and sisters are going
crazy about that.”
“We could have a fresh-air children’s chorus,” Binks added promptly.
“I mean children brought up to go barefoot and sleep outdoors in
winter and all that sort of foolishness.”
“With a special number about women that get up early and walk
barefoot in the dewy grass,” put in Georgia eagerly.
“And we could have a home-beautiful monologue.”
“Never mind going any further, Binks,” Georgia told her firmly. “There
is evidently no lack of material for an extra-special show entitled
Jists and Suffragists.”
“Jists?” repeated Binks blankly.
“Jists—jests, jokes. Didn’t you ever hear of a merry jist, my peculiar
young cousin from Boston?”
“Well, I have now,” said Binks imperturbably. “And it will be no merry
jist at all if I’m not on hand at four to go walking with the Poetess.
So I must rush home. You think the faculty and Miss Wales will be
sure to approve, don’t you?”
“Oh, yes, I’m sure they will, but you’d better not assign the jist and
suffragist parts to your little friends until you hear from me,” advised
Georgia. “It’s considered good form not to be too sure in advance of
faculty permits.”
When Binks had gone, Georgia lay back on her broad window-seat
and chuckled. “She’s all right, is my peculiar cousin,” Georgia
reflected. “Jists and Suffragists will drag her into Dramatic Club
without any help from me. And she doesn’t know it. She wouldn’t
care if she did know it. And I almost let Clio Club get her, just
because she was in the family and so I never appreciated her! Well,
I appreciate her now. I guess I’ll go and find Betty and get her to
come with me to see Miss Ferris about the extra-special show.”

Never in the whole history of Harding College had there been a more
successful affair than Binks’s altogether impromptu, go-as-you-
please Benefit Performance. Binks’s method of arranging the various
stunts was quite simple.
“Is your mother a club-woman?” she demanded of each prospective
head of a committee. “Well, is she a fresh-air fiend? Or a
Suffragette? Or does she go in hard for exercise? She does? Then
won’t you please be Georgia’s right-hand man on her committee?
Georgia is getting up some killing kind of a dance, to make fun of
the exercise business.
“Now, Susanna, you were brought up on fresh air, and you can write
songs. Write one for a chorus of fresh-air-brought-up children, won’t
you? You can choose your own chorus to sing the song, and consult
with them about costumes and all that sort of thing.”
It worked like a charm, Binks’s method.
“You see,” Fluffy explained it, “a clever girl is sure to have a clever
mother, and nowadays all clever mothers have fads. Ours has the
no-breakfast fad. Straight is trying to write a one-act tragedy
entitled, ‘Before Breakfast, Never After.’ It will be tragic all right if it
goes the way I felt the summer that I obligingly tried to join the
anti-breakfast crusade.” Fluffy, who was engaged at the moment in
eating a particularly hearty breakfast at the Tally-ho, returned
happily to her second order of waffles.
Of course the B. C. A.’s heard about the extra-special show, and
Madeline, who was still in Harding celebrating the acceptance of her
novel, could not resist the lure of a project so congenial. She wrote
Binks a modest little note offering to write a one-act farce entitled,
“Waiting Dinner for Mother; or, The Meal-Hour and the Artistic
Temperament.”
“It will be founded on my personal observations,” Madeline wrote,
“and maybe it will be amusing, because living in Bohemia New York
used to be very amusing indeed, in spite of too much artistic
temperament getting into the cooking. I think our post-graduate
crowd would act it out for me, and then I shouldn’t be making you
any bother.”
“Bother!” repeated Binks, reading the note, which she had just
picked off the bulletin-board, aloud to a circle of friends. “Bother!
She’s written a play for Agatha Dwight—a really-truly play that you
sit in two dollar seats to see. And she hopes it won’t be a bother if
she writes one for this show!” Binks, who was not yet a recognized

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