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PubMed1990

Conflict over emotional expression: psychological and physical correlates.

This study addresses the construct of conflict or ambivalence over emotional expression. Ambivalence is seen as an important mediator in the link between emotional styles and psychological and physical well-being. Using the "personal striving" framework, a questionnaire measure of ambivalent emotional strivings (AEQ) was designed. In Study 1, 292 Ss completed this measure along with questionnaire measures of expressiveness, social desirability, and intense ambivalence. Women scored significantly higher than men on both the AEQ and expressiveness. In Study 2, scores on the AEQ were found to be negatively correlated with self-reported and peer-rated expressiveness. In Study 3, 48 Ss participated in a 21-day study of mood and health. Expressiveness was positively correlated with some measures of well-being and with daily negative affect. Ambivalence was positively correlated with several indices of psychological distress. Although the AEQ correlated with questionnaire measures of physical symptomatology, neither the AEQ nor the expressiveness measures correlated with daily symptom reports. Results support the contention that conflict over emotional expressiveness is a variable worthy of study in its own right, having implications for research on personality and health.

Adaptation, Psychological↗
PubMed2005

Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics.

This exploratory study contrasted and tested the predictive value of the reverse buffering hypothesis of social support and the information processing model of posttraumatic stress disorder (PTSD) in an investigation of trauma-related symptomatology (TRS) in a single sample of 42 student paramedics. Participants completed several anonymous self-report measures of PTSD symptomatology, peer social support, and attitude toward emotional expression. Regression-based path analyses did not support either theory of PTSD in this population. A path model of PTSD in student paramedics was subsequently developed, indicating that a direct relationship exists between duty-related trauma exposure, dysfunctional peer social support, and students' negative attitudes toward emotional expression. This new model accounted for 30% of the variance in student paramedics' TRS.

Adult↗
PubMed1997

Attitudes towards emotional expression and post-traumatic stress in survivors of the Herald of Free Enterprise disaster.

The relationship between self-reported attitudes towards emotional expression, assessed at three years after the accident, and post-traumatic symptoms, assessed at five years after the accident, was investigated in 37 survivors of the Herald of Free Enterprise disaster. It was found that lower scores on the attitudes towards emotional expression scale, indicating more negative attitudes (e.g. 'I think getting emotional is a sign of weakness') were associated with higher symptom scores. This association remained even when retrospectively assessed perceptions of helplessness during the disaster and symptoms assessed at three years were partialled out. Implications for therapeutic intervention are discussed.

Accidents, Traffic↗
PubMed2005

Parental socialization of emotion expression: gender differences and relations to child adjustment.

The present study examined gender differences in children's submissive and disharmonious emotions and parental attention to these emotions. Sixty children and their mothers and fathers participated when children were 4 and 6 years old. Children's emotion expression and parental responses during a game were coded. Girls expressed more submissive emotion than boys. Fathers attended more to girls' submissive emotion than to boys' at preschool age. Fathers attended more to boys' disharmonious emotion than to girls' at early school age. Parental attention at preschool age predicted later submissive expression level. Child disharmonious emotion predicted later externalizing symptoms. Gender differences in these emotions may occur as early as preschool age and may be subject to differential responding, particularly by fathers.

Attention↗
PubMed1993

Rationality, emotional expression and control: psychometric characteristics of a questionnaire for research in psycho-oncology.

In some studies rationality, anti-emotionality and the control of (negative) emotions were found to be psychological risk factors for cancer. In the present study instruments were developed in order to cross-validate the role of the 'rationality/anti-emotionality (RAE)'-concept and the 'emotional expression and control (EEC)'-concept. The psychometric characteristics of a RAE-scale and EEC-scales were investigated in 4302 healthy women attending a breast cancer screening programme in The Netherlands. Principal components analysis revealed three factors for the RAE-scale: (1) Rationality; (2) Emotionality; and (3) Understanding. The EEC-scales consist of three factors that indicate: (1) expression of emotions to oneself; (2) expression of emotions towards others; and (3) control of emotions. These RAE and EEC scales can be of importance in psycho-oncological research, especially when: (1) the more refined subscales are used; and (2) age of the subjects is taken into account.

Adult↗
PubMed1998

Written emotional expression: effect sizes, outcome types, and moderating variables.

A research synthesis was conducted to examine the relationship between a written emotional expression task and subsequent health. This writing task was found to lead to significantly improved health outcomes in healthy participants. Health was enhanced in 4 outcome types--reported physical health, psychological well-being, physiological functioning, and general functioning--but health behaviors were not influenced. Writing also increased immediate (pre- to postwriting) distress, which was unrelated to health outcomes. The relation between written emotional expression and health was moderated by a number of variables, including the use of college students as participants, gender, duration of the manipulation, publication status of the study, and specific writing content instructions.

Affect↗
PubMed2002

Age, expressed emotion, and interpersonal control patterning in families of persons with schizophrenia.

Expressed emotion (EE) is a measure of a relative's attitude toward a person with a mental disorder as reflected by comments made to an interviewer. Over the years, an impressive body of research has been generated in attempts to explain the relationship of EE and course of illness, particularly in regard to schizophrenia. Past analyses have demonstrated two common patterns of interpersonal control in families with high-EE relatives. The first was that the relative and patient competed for 'who's in charge', with both rigidly asserting control. The other was that the relatives responded rigidly in one control mode no matter what the offspring was saying. In this study, we tested whether the difference in patterning was due to the patients being older. Study participants were 71 relative-patient dyads. EE was measured with the Five-Minute Speech Sample, the Family Problem-Solving Task was used to generate interaction, and interaction data were coded with the Relational Control Coding System. Multilevel modeling was used to estimate a model with verbal exchanges as Level 1, relatives' EE as Level 2, and age of the patient as Level 3. Results showed that age attenuated the relationship between the patient's message and the parent's response, and this effect was stronger in families with high-EE relatives. This effect may reflect disengagement on the part of the relative, the patient, or both. The over-responsive families may need advice on how to create more distance, or how to be more objective, but the distant families may need more support and encouragement to communicate and problem-solve.

Adult↗
PubMed1993

Predictive validity of the Level of Expressed Emotion (LEE) Scale: readmission follow-up data for 1, 2, and 5-year periods.

The predictive validity of the Level of Expressed Emotion (LEE) Scale in a group of schizophrenic patients was examined. Forty-six patients with DSM-III diagnoses of schizophrenic disorders were administered the perceived expressed emotion measure (LEE) and followed up for a 5-year period. Patients' ratings of their social environments were related to rehospitalization 1 year, 2 years (p < .02) and 5 years (p < .01) after initial assessment. These results supported the utility of the LEE in identifying schizophrenic patients at high risk for rehospitalization.

Adult↗
PubMed2003

Longitudinal relations among parental emotional expressivity, children's regulation, and quality of socioemotional functioning.

The role of regulation as a mediator of the relations between maternal emotional expressivity and children's adjustment and social competence was examined when children (N = 208) were 4.5 to just 8 years old (Time 1, T1) and 2 years later (Time 2, T2). At T2, as at T1, regulation mediated the relation between positive maternal emotional expressivity and children's functioning. When T1 relations and the stability of variables over time were controlled for in a structural equation model, T2 relations generally were nonsignificant, although parents' dominant negative expressivity predicted high regulation. In contrast, in regressions, the findings for parent positive expressivity, but not negative expressivity, held at T2 when T1 variables were controlled. Thus, relations for negative expressivity, but not positive expressivity, changed with age.

Affect↗
PubMed2003

Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression.

The differences in affective status between patients who restrain their negative emotion and those who express negative emotion after being given their breast cancer diagnosis were studied using the Profile of Mood States (POMS) at two sessions: (i) at the first visit to the outpatient surgery clinic, and (ii) immediately after being given the diagnosis of breast cancer. Eighty-seven patients completed the POMS and the Courtauld Emotional Control Scale (CECS) at the first visit to the outpatient surgery clinic at Shiga University of Medical Science Hospital. They also completed the POMS immediately after being given the diagnosis of breast cancer. Breast cancer patients who restrain their negative emotion (n = 8) were highly anxious, depressed and confused after being given the diagnosis compared to breast cancer patients who express negative emotion (n = 8). Emotional distress in benign breast tumor patients was reduced after being given the diagnosis regardless of the trend of emotional inhibition. That is, emotional distress in patients who restrain their emotions was considerably increased compared with that of patients who expressed their emotions when they were faced with a life-threatening disease. These results suggest that it may be therapeutic to advise breast cancer patients to express their negative emotion.

Adaptation, Psychological↗
PubMed2002

Evaluation of expressed emotion in schizophrenia: a comparison of Caucasians and Mexican-Americans.

Social desirability, while a recognized source of respondent bias among Mexican-Americans, has not been evaluated as an explanation for the lower rate of high expressed emotion (EE) found in the family members of Mexican-Americans versus Caucasians with schizophrenia. In this study, we tested the hypothesis that the lower rate of high EE (hostility and criticism) among Mexican-Americans was the result of cultural factors impacting on how information was reported by the Mexican-American relative of a patient with schizophrenia. We compared the ratings of EE between Caucasian (N = 17) and Mexican-American (N = 44) patients with schizophrenia or schizoaffective disorder and their key relatives using the level of expressed emotion (LEE) scale (paper and pencil instrument rated by the patient and relative separately) and the Five Minute Speech Sample (observational experimenter rated). The ability of the various measures to predict relapse over two years was also examined. Contrary to our hypothesis, there were no differences between patient and family measures within ethnic group. Mexican-American patients and relatives reported lower rates of high EE than Caucasians across all measures. High EE predicted relapse across measures for Caucasian participants, but did not predict relapse for Mexican-Americans on any of the measurement instruments. We discuss the implications of these findings on cross-cultural research and family interventions for individuals with psychotic disorders.

Adult↗
PubMed1989

Expressed emotion and nursing the schizophrenic patient.

The findings from the family studies of schizophrenic family members' readmission (which coined the term 'expressed emotion' to explain why some families have members who need readmission more often than others) are related to a variety of areas of psychiatric nursing research, including nurses' attitudes, nurses' behaviour, ward atmosphere, institutionalization, social therapy, and patient outcome. This follows the Berkowitz & Heinel report that psychiatric nurses at one hospital behave like the families that have lower readmission rates. A strategy for further research of psychiatric nurses 'expressed emotion' is proposed, in relation to the course and outcome of schizophrenic patients' hospitalization.

Attitude of Health Personnel↗
PubMed1990

Comparisons of two expressed emotion scales with the Camberwell Family Interview.

The relationship of the Camberwell Family Interview (CFI) with two self-report scales purported to measure levels of expressed emotion was assessed. Fifteen schizophrenic patients and 22 of their relatives completed the Level of Expressed Emotion Scale (LEE) and the Influential Relationships Questionnaire (IRQ). The relatives of patients also participated in Camberwell Family Interviews (CFI). Results supported the value of the self-report measures in evaluating the affective environment of patients with schizophrenia.

Adult↗
PubMed1992

Social facilitation and inhibition of emotional expression and communication.

Does the presence of others facilitate or inhibit emotional expression? Female "senders" (n = 45) viewed 12 emotionally loaded slides either alone or with another sender while responses were secretly videotaped. In Study 1, 14 "receivers" guessed the type of slide viewed by dyads more accurately (eta = .366). In Study 2, 42 receivers viewed 10 senders with friends, 10 with strangers, and 10 alone. One dyad member was covered so that only 1 sender was visible. Analysis revealed significant effects of condition (alone, friend, or stranger; eta = .456), slide type (sexual, scenic, unpleasant, or unusual; eta = .325), and the Condition x Slide Type interaction (eta = .350). Strangers had overall inhibitory effects on communication accuracy, whereas friends had facilitative effects on some slides and inhibitory effects on others. Thus, both social facilitation and inhibition of expression occurred on the basis of the emotional stimulus and personal relationship involved.

Adult↗
PubMed1990

The application of the concept of expressed emotion to the role of the community psychiatric nurse: a research study.

The previous article examined the development of the concept of 'expressed emotion', argued that controlled studies had successfully demonstrated the value of psychosocial intervention, but demonstrated that such a therapeutic approach had been mostly limited to the research studies themselves. In the light of the demonstrable efficacy of psychosocial intervention, the psychiatric nursing literature is reviewed in order to establish how far nurses have capitalized on the utility of the 'expressed emotion' concept, to date, in their work with schizophrenic clients and their families. In addition, a brief historical overview of the Community Psychiatric Nurses' (CPNs) role with schizophrenic clients is presented which relates to current ongoing research in this area which is described. In brief, the research project, which is funded by the Department of Health, is evaluating the outcome of teaching CPNs to deliver psychosocial interventions to families caring for a schizophrenic relative at home.

Community Mental Health Services↗
PubMed2000

Perceived expressed emotion in the siblings and parents of hospitalized patients with anorexia nervosa.

OBJECTIVE: The present study investigated the relationship between the level of perceived Expressed Emotion (EE) of the siblings and parents of patients hospitalized with anorexia nervosa and its effect on weight gain and psychological functioning. METHOD: The Level of Expressed Emotion (LEE) Scale was administered on admission to 19 patients with anorexia nervosa who completed the LEE three times so as to identify their perceptions of their relationship with their closest age sibling, mother, and father. They were also required to complete the Eating Disorder Inventory 2 (EDI-2). Patients' closest age sibling completed the Family Attitude Scale (FAS). The patients' body mass index (BMI) was calculated 6 weeks later, and the EDI-2 readministered. RESULTS: Perceived EE was not predictive of BMI change after 6 weeks of hospitalization. A composite perceived family EE score was a significant predictor of change on the Interpersonal Distrust, Maturity Fears, and Perfectionism subscales of the EDI-2. DISCUSSION: These findings suggest that patients' perceptions of their relationships with their closest aged sibling, mother, and father are poor predictors of weight gain and improvement in psychological functioning following 6 weeks of inpatient treatment.

Adult↗
PubMed1995

Expressed emotion, family dynamics and symptom severity in a predictive model of social adjustment for schizophrenic young adults.

While numerous studies have concluded that high expressed emotion (EE) in relatives predicts relapse in schizophrenia, other aspects of patient outcome have not been well studied. Our purpose was to determine the extent to which family dynamics and expressed emotion may predict variance in patient social adjustment when controlling for symptom severity. Sixty-nine schizophrenic outpatients and 108 of their relatives participated. Relatives' EE was assessed, and they were administered the FACES III for perceptions of family cohesion and adaptability. Patients were interviewed at about the same time as their relatives and again 9 months later with the Social Adjustment Scale (SAS-II) and the BPRS. Between 9% and 58% of variance in each of the five SAS scales was explained by selected EE and family dynamics scales, while symptom severity was held constant. Among the results, it was found that better social adjustment in patients was associated with less family adaptability, and with greater emotional overinvolvement in relatives. Adjustment of patients in the work role was associated with more Critical Comments from mothers. In conclusion, some aspects of high EE are associated with better social adjustment in schizophrenic patients.

Adolescent↗
PubMed2003

Emotional expressiveness, hostility and blood pressure in a longitudinal cohort of Alzheimer caregivers.

OBJECTIVE: To assess the interactive effect of chronic stress and emotional expressiveness (EE) on blood pressure (BP) in older adults. METHOD: Among spousal caregivers (n=111) of Alzheimer's disease (AD) patients, BP was assessed at home by a visiting nurse every 6 months for 7 years. Caregiving demands, EE, social desirability and hostility were also assessed. RESULTS: State hostility was more prevalent among newer caregivers and those encountering more dementia problem behaviors and ADL limitations but unrelated to BP or BP change (P>.05). In a cross-sectional analysis, higher diastolic BP was associated with more spousal problem behaviors and being less emotionally expressive (P<.05). Longitudinal (growth curve analysis) increases in diastolic BP were predicted by providing more spousal ADL assistance (P<.05) but not by EE. CONCLUSION: Both caregiving stress and low EE may contribute independently to hypertension risk in the elderly.

Activities of Daily Living↗