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PubMed1999

Emotional expression and feeling in schizophrenia: effects of specific expressive behaviors on emotional experiences.

The purpose of this study was to investigate the relationship between emotional expression and experience in schizophrenia by manipulating expressive behaviors directly and then assessing subsequent emotional feelings. In Study 1, facial expressions and bodily postures were manipulated in a sample of normals, the results of which replicate findings from previous studies of peripheral feedback effects on emotions. In Study 2, the same procedures were used with matched groups of outpatient schizophrenic men, patients with depression, and nonpsychiatric controls. Schizophrenia patients showed the usual effects from their facial expressions of sadness, fear, happiness, and surprise, but only from their postures of anger, whereas patients with depression showed the same effects only from their expressions and postures of sadness, and normal controls only from their expressions and postures of anger. These patterns may reflect those aspects of the emotional response system that are functional and dysfunctional in schizophrenia and depression.

Adolescent↗
PubMed2000

The expressed emotion of case managers of the seriously mentally ill: the influence of expressed emotion on clinical outcomes.

BACKGROUND: Expressed emotion (EE) measured from relatives and informal carers has been consistently demonstrated to be associated with clinical outcome in schizophrenic patients. There have also been published studies that have investigated EE in professional carers that have suggested that the quality of the relationship between staff and patient may also be associated with patient outcomes. A large controlled trial of the effectiveness of different intensities of case management provided the opportunity to assess the association between the EE of case managers, including the quality of the relationship they had with patients under their care, and later clinical outcomes. METHOD: This was a prospective naturalistic study of EE present in a case manager patient dyad and subsequent patient outcomes. EE was assessed from the Five Minute Speech Sample (FMSS) at least 3 months after the case manager became responsible for the patient's care and a range of clinical outcomes were assessed 6 to 9 months later. Assessment of clinical outcomes was made independent and blind of the EE ratings. RESULTS: High EE ratings were significantly associated with individual case managers and not to symptom or illness factors. High EE was not associated with later clinical outcome, however, the positive relationship between case manager and patient was. The absence of a positive relationship was significantly associated with poorer outcomes. CONCLUSIONS: In spite of very low face-to-face contact between case managers and patients, compared with the amount of contact patients have with their informal carers and family, aspects of staff attitudes and behaviour did influence clinical outcome. There are potential implications of these results for staff training and clinical practice.

Adult↗
PubMed1987

Expressed emotion and schizophrenia in north India. II. Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh.

We measured the components of expressed emotion among two samples of relatives of first-contact patients from Aarhus (Denmark) and Chandigarh (India). The Danes were very similar in most respects to samples of British relatives, whereas the Indian relatives expressed significantly fewer critical comments, fewer positive remarks, and less over-involvement. Within the Chandigarh sample, city-dwellers were significantly more expressive than villagers of all EE components except over-involvement.

Adolescent↗
PubMed2002

The effect of parental expressed emotion on glycaemic control in children with Type 1 diabetes. Parental expressed emotion and glycaemic control in children.

OBJECTIVE: To measure expressed emotion (EE) in parents of young children with diabetes and to examine the relation between EE and glycaemic control in children with Type 1 diabetes in a longitudinal study over 24 months. We hypothesised that good glycaemic control, as measured by low glycated haemoglobin levels, would be predicted by high parental emotional over-involvement, low frequency of critical comments and absence of hostility. We predicted that these effects would be stronger in maternal than paternal scores. METHODS: Forty-seven children attending a Paediatric Diabetes Clinic and their parents were studied over 24 months. Glycated haemoglobin was measured on three occasions, at the start of the study period, 12 and 24 months later. At 12 months, parental EE was measured using an adapted version of the Camberwell Family Interview, and child emotional and behavioural problems were measured using the parent version of the Child Behavior Checklist. Multiple regression models were used to test the hypotheses. RESULTS: Forty-three maternal and 33 paternal interviews of adequate quality for analysis were obtained. Paternal hostility was found to be associated with elevated glycated haemoglobin measured 12 months before interview and 12 months after interview, accounting for 22% and 29% of the variation in glycated haemoglobin respectively. CONCLUSIONS: We did not find that parental emotional over-involvement or criticism predicted glycaemic control. Presence of hostility was important, but in contrast to our hypothesis, this was paternal rather than maternal hostility. We suggest that (i) relatively absent, rejecting fathers play little role in diabetes management and children perceive this negatively, or (ii) mothers who are unsupported by fathers cannot in turn support their children in diabetes care.

Adolescent↗
PubMed2006

Perceived criticism in schizophrenia: a comparison of instruments for the assessment of the patient's perspective and its relation to relatives' expressed emotion.

The expression and perception of expressed emotion (EE) in schizophrenic patients and their relatives are likely to differ. The presented exploratory study compares the two views. EE in relatives of 25 chronic schizophrenic patients was assessed using an extended version of the Five-Minute Speech Sample (FMSS). Patients rated their relatives with the Perceived Criticism Scale (PCS), the Family Emotional Involvement and Criticism Scale (FEICS), and a German questionnaire on family atmosphere (FEF). Forty-eight percent of relatives were rated high in EE, due to criticism in all cases but one. Patients' assessments of the whole family on the FEICS and FEF criticism subscales were related to their relatives' EE status. Correlations between the self-rating instruments were moderate to good. As the patients' and the relatives' views corresponded with regard to the criticism domain, the application of a self-rating instrument may be a simple and useful tool for clinical and research purposes.

Adult↗
PubMed1990

Perceived intimacy of expressed emotion.

Research on norms for emotional expression and self-disclosure provided the basis for two hypotheses concerning the perceived intimacy of emotional self-disclosure. The first hypothesis was that the perceived intimacy of negative emotional disclosure would be greater than that of positive emotional disclosure; the second was that disclosures of more intense emotional states would be perceived as more intimate than disclosures of less intense emotional states for both negative and positive disclosures. Both hypotheses received support when male students in Canada rated the perceived intimacy of self-disclosures that were equated for topic and that covered a comprehensive sample of emotions and a range of emotional intensities. The effects were observed across all the topics of disclosure examined.

Adolescent↗
PubMedDate not supplied

[Emotional expression: from research to psychosocial treatment].

Over a four year period, the Schizophrenia Research Association (A.R.S. - Associazione Ricerche sulla Schizofrenia) has drawn up a multi-dimensional plan of action for the families of schizophrenic subjects. The basic points of this plan revolve around advice to the family and group therapy for family members, split into "informative" and "relationship orientation" sessions. Conducting an assessment of Expressed Emotion on family members admitted to these groups, it was observed that their emotional make-up is very different from that of family members of schizophrenics selected on the basis of casual criteria. Therefore, we are proposing a strategy which takes into account the emotional make-up of the family member in dictating therapists' action in terms of each family member.

Emotions↗
PubMed1995

[Stability and predictive role of emotions, expressed by families in the development of a cohort of schizophrenic patients in the course of 5 years].

A prospective study of 44 first admission schizophrenic patients was conducted in Geneva, in order to evaluate the prognostic value of Expressed Emotion (EE), as well as its stability. The predictive power of the EE index was tested on three variables of outcome: relapse rate, social adaptation and hospital stay. At intake, the patients presenting more premorbid features lived in high EE households. The EE index and the outcome measures tended to be associated. After the third year, patients living with high EE relatives were significantly more maladjusted and relapsed more than those living with low EE relatives. The EE index was stable during the five years. Our results show that initial measure of EE in a first episode cohort is predictive of outcome over a five year period. This may not be causal as it cannot be excluded that poorer premorbid functioning alone may result in poorer outcome, and may also elicit high EE in relative.

Adult↗
PubMed1987

Expressed emotion and schizophrenia in north India. III. Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh.

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo-American studies for 'high EE', we found a significant relationship between high EE and relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.

Attitude to Health↗
PubMed2003

Early processing of the six basic facial emotional expressions.

Facial emotions represent an important part of non-verbal communication used in everyday life. Recent studies on emotional processing have implicated differing brain regions for different emotions, but little has been determined on the timing of this processing. Here we presented a large number of unfamiliar faces expressing the six basic emotions, plus neutral faces, to 26 young adults while recording event-related potentials (ERPs). Subjects were naive with respect to the specific questions investigated; it was an implicit emotional task. ERPs showed global effects of emotion from 90 ms (P1), while latency and amplitude differences among emotional expressions were seen from 140 ms (N170 component). Positive emotions evoked N170 significantly earlier than negative emotions and the amplitude of N170 evoked by fearful faces was larger than neutral or surprised faces. At longer latencies (330-420 ms) at fronto-central sites, we also found a different pattern of effects among emotions. Localization analyses confirmed the superior and middle-temporal regions for early processing of facial expressions; the negative emotions elicited later, distinctive activations. The data support a model of automatic, rapid processing of emotional expressions.

Adult↗
PubMed1992

The measurement of expressed emotion: a review.

Expressed emotion refers to the affective attitudes and behaviours (i.e., criticism, hostility and emotional overinvolvement) of relatives toward a family member with a psychiatric illness. In this article, the Camberwell Family Interview, the standard method used to assess expressed emotion, and alternative approaches to the measurement of expressed emotion are reviewed. While there is a reasonable correspondence between ratings derived from the Camberwell interview and the less arduous alternative methods, the association is not perfect. In addition, the conceptual similarities and prognostic utility of these measures require replication and further exploration. Of the alternative assessment methods available, the use of the Five Minute Speech Sample or the Level of Expressed Emotion Scale as screening devices is recommended.

Attitude to Health↗
PubMed1994

Family-expressed emotion, childhood-onset depression, and childhood-onset schizophrenia spectrum disorders: is expressed emotion a nonspecific correlate of child psychopathology or a specific risk factor for depression?

Expressed emotion (EE) was examined, using the brief Five Minute Speech Sample measure, in families of (1) children with depressive disorders, (2) children with schizophrenia spectrum disorders, and (3) normal controls screened for the absence of psychiatric disorder. Consistent with the hypothesis of some specificity in the association between EE and the form of child disorder, rates of EE were significantly higher among families of depressed children compared to families of normal controls and families of children with schizophrenia spectrum disorders. Within the depressed group, the presence of a comorbid disruptive behavior disorder was associated with high levels of critical EE, underscoring the need to attend to comorbid patterns and subtypes of EE in future research.

Adolescent↗
PubMed1998

Hemifacial asymmetry in emotion expressions.

We examined asymmetry in posed facial expression of emotions: happy and sad. Hemifacial composite photographs, left-left and right-right, were prepared, and subjects rated these for intensity of expressed emotion. Overall, left-left composites were judged to have expressed emotions relatively more intensely than the right-right composites. The significant Sex x Emotion interaction revealed that female expressors were judged as more expressive than male expressors in expressing sad facial emotion. Sex difference in expression of happy facial emotion was not significant.

Adult↗
PubMed2006

Attention to facial emotion expressions in children with autism.

High-functioning children in the autism spectrum are frequently noted for their impaired attention to facial expressions of emotions. In this study, we examined whether attention to emotion cues in others could be enhanced in children with autism, by varying the relevance of children's attention to emotion expressions. Twenty-eight high-functioning boys with autism and 31 boys from a control group were asked to sort photos depicting smiling or frowning faces of adults. As found in earlier studies, in neutral conditions children with autism were less attentive to emotion expressions than children from a control group. This difference disappeared when children were explicitly asked to make a socially relevant decision. These findings suggest that the attention of children with autism to emotion expressions in others is influenced by situational factors. Theoretical implications of these findings are discussed.

Affect↗
PubMed1994

Individual differences in dispositional expressiveness: development and validation of the Emotional Expressivity Scale.

Although emotional expressivity figures prominently in several theories of psychological and physical functioning, limitations of currently available measurement techniques impede precise and economical testing of these theories. The 17-item Emotional Expressivity Scale (EES) was designed as a self-report measure of the extent to which people outwardly display their emotions. Reliability studies showed the EES to be an internally consistent and stable individual-difference measure. Validational studies established initial convergent and discriminant validities, a moderate relationship between self-rated and other-rated expression, and correspondence between self-report and laboratory-measured expressiveness using both college student and community populations. The potential for the EES to promote and integrate findings across diverse areas of research is discussed.

Adolescent↗
PubMed1981

Emotional expressivity and sex-role perceptions of repressors and sensitizers.

Two studies were conducted examining the contributions of repression-sensitization (R-S) status, sex-role perceptions, and sex of the target of expressivity to assess the expression of emotional discomfort by males, in Experiment I verbal and nonverbal measures of emotional expressiveness were obtained for male repressors and sensitizers exposed to neutral or moderately negative arousal situations with sex of the target of the expressiveness controlled. In Experiment 2 repressors were found to be sex-typed masculine and male sensitizers sex-reversed in their sex-role perceptions. The usefulness of R-S status and sex, role perceptions to predicting emotional expressivity by males is discussed.

Journal Article↗