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PubMed1995

Expressed emotion, communication deviance and schizophrenia. An exploratory study of the relationship between two family variables and the course and outcome of a psychoeducational treatment programme.

The relationship between expressed emotion (EE) and communication deviance (CD), and outcome in a group of early-onset schizophrenics after 2 years of psychoeducational treatment was examined. Patients' parents were assessed on EE and CD before and after the 2-year period. Outcome was measured by Global Assessment Scale (GAS) and relapse rate. Results showed that the correlation between CD and outcome was higher than between EE and outcome. In most of the patients who improved their GAS score during the treatment programme, their parents changed from high to low EE. CD proved to be more resistant to psychosocial intervention than EE.

Adolescent↗
PubMed1992

Expressed emotion and schizophrenia in Italy. A study of an urban population.

Forty-two schizophrenic patients and their close relatives took part in an Italian replication study of expressed emotion (EE). The patients were selected from the psychiatric ward of a general hospital in Milan and were subsequently followed up for nine months. All patients attended a community service clinic as out-patients, and all but one were prescribed neuroleptics for the duration of the study. Relatives were assigned to the high-EE group if they scored 4 or 5 on the emotional overinvolvement (EOI) scale, or showed hostility, or made six or more critical comments. On this basis, 18 (42%) families were rated as low EE and 24 (57%) as high EE. At follow-up, the admission rate for the 9-month period was significantly higher for the high-EE group (P less than 0.05). Furthermore, significantly fewer patients were readmitted from families showing high warmth (P less than 0.05). The presence of high warmth appeared to be associated with a lower admission rate, even in high-EE families.

Adult↗
PubMed1995

[Family intervention for schizophrenia based on expressed emotion (EE) research: a review of the technique and evaluation].

The present study reviews eight series of trials on psycho-social family intervention for schizophrenia based on Expressed Emotion (EE). All studies used randomized controlled trials (RCT) except one which was non-randomized controlled trial. The relapse risk ratios (intervention/control) for 9-12 months after discharge were 0 to .73 and for 24 months were .20 to .57. Taking into account the shortcomings of the studies, the authors conclude that psycho-social family intervention based on EE is effective in preventing schizophrenic relapse, and discuss four important issues: 1) For effective family intervention, methods for Japanese patients should be established from a trans-cultural view point; 2) The interaction of two or more therapeutic measures should be evaluated quantitatively; 3) The mechanisms of schizophrenic relapse prevention through family psycho-social intervention should be explored. A psycho-physiological study including skin conductance measurement is promising; 4) The authors point out the ethical aspect of family intervention, and discuss the importance of informed consent and the need to place emphasis on family's needs.

Emotions↗
PubMed1992

Type A behavior pattern and emotion expression in younger and older adults.

Eighty younger (less than 50 years, M = 28 years) and 80 older (more than 50 years, M = 69 years) Type A and Type B Ss were evaluated for Type A behavior pattern using the Structured Interview (SI) and given personality tests for anxiety, depression, anger, aggression, hostility, and anger-in-anger-out. Ss also underwent an emotion induction procedure. Videotapes of the emotion induction procedure (N = 160) and the SI (N = 80) were coded for facial expression of emotion. Type As did not differ from Bs on anxiety or depression but did on anger and aggression. Type As showed anger inhibition and anger bound to shame, as predicted by emotion socialization theory. The greatest number of differential effects were observed between age groups. Older individuals, in general, were more emotionally expressive than younger Ss across a range of emotions. Women appeared more conflicted about anger expression than men, and Type A women more so than Type A men.

Adult↗
PubMed2006

The recognition of emotional expression in prosopagnosia: decoding whole and part faces.

Prosopagnosia is currently viewed within the constraints of two competing theories of face recognition, one highlighting the analysis of features, the other focusing on configural processing of the whole face. This study investigated the role of feature analysis versus whole face configural processing in the recognition of facial expression. A prosopagnosic patient, SC made expression decisions from whole and incomplete (eyes-only and mouth-only) faces where features had been obscured. SC was impaired at recognizing some (e.g., anger, sadness, and fear), but not all (e.g., happiness) emotional expressions from the whole face. Analyses of his performance on incomplete faces indicated that his recognition of some expressions actually improved relative to his performance on the whole face condition. We argue that in SC interference from damaged configural processes seem to override an intact ability to utilize part-based or local feature cues.

Adult↗
PubMed1993

Topics and signs: defensive control of emotional expression.

This single-case study examined frank disclosure of important topics in a brief exploratory psychotherapy, including topics closely related to a recent, unintegrated stressor life event. Quantitative measures of emotion and control variables showed heightened levels of both emotionally and defensive control during discourse on the topic of the stressor event. In future studies, such measures of verbal and nonverbal signs of emotional expression and defensive control might be used to identify topics in an unresolved state.

Adjustment Disorders↗
PubMed1986

[Perceptual categorization of emotional expression cued by ones back posture].

Subjects looked at 8 mm motion pictures of the bodily movement from rear view perspective of male and female communicators, who faced to emotionally-toned scenes. If the subjects detected some sign of emotional expression, they rated the relevance of expression on five point scale. Varimax rotated factor analysis yielded three factors: F1 rejection-acceptance, F2 avoidance-approach, and F3 sadness. Rejection was categorized as expressions of anger, disgust, and contempt, while anger was categorized when a clenched fist with forward and extended arm were observed. Disgust and contempt were categorized when stationary posture was observed. Acceptance was categorized when the signs of affection, anticipation, and acceptance were observed. Avoidance was categorized when signs of fear and surprise were observed. A typical fear was categorized when signs of freezing was observed, surprise was categorized by stepping back, and sadness was categorized by crouching and self attachment.

Adult↗
PubMed2002

Measurement of the perception of facially expressed emotions by a computerized device: method of analysis and research for the integration of emotions (MARIE).

Current computerized tools allow detailed exploration of the structure and functioning of the "black box," i.e., human cognitive and affective systems as well as thought. This technology was used to study the visual perception of facially expressed emotions. Morphological transition from one canonical emotion to another led to the creation of a continuum of intermediary pictures, and the identification of perceived emotions by 65 normal subjects was measured. We call this application "MARIE" (in French: Méthode d'Analyse et de Recherche de l'Intégration des Emotions; Method of Study and Analysis of Integration of Emotions). Our study examined the relationship between the quantitative modification of the continuum and the quantitative variation of the responses. Standardization of graphs led to the assessment of the two parameters of a Laplace-Gauss curve, i.e., mean and standard deviation. It is argued that such a tool could be very useful in the clinical assessment of the emotional state of subjects and/or of patients.

Adult↗
PubMed1991

Expressed emotion and early onset schizophrenia: a one year follow-up.

Key relatives of 33 first or early admission psychotic patients (mainly schizophrenics) were interviewed to determine household levels of expressed emotion (EE). The patients were followed up for 12 months from index admission, during which time 13 (39%) experienced psychotic relapse. There was no association between relapse rate and household EE, but correlations between individual components of EE and pre-morbid measures suggest that level of criticism may be related to less acute onset of index episode, greater elapsed time since first signs of illness, and poor adjustment in the realm of work/study. The results are discussed in the context of continuing uncertainties about the precise nature of the relationship between EE and relapse.

Adult↗
PubMedDate not supplied

Maternal expressed emotion and metabolic control of children and adolescents with diabetes mellitus.

BACKGROUND: The objectives of this study of children and adolescents with diabetes were to: (1) examine whether maternal expressed emotion (EE), in the form of critical comments (CC), hostility and emotional overinvolvement (EOI), is related to metabolic control; (2) determine if CC and EOI are separately related to poor metabolic control, and (3) ascertain whether high EE is related to psychopathology in these children. METHODS: The Present Episode version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS-P/K-SADS-P) interview was administered to 55 children and adolescents with diabetes and the parental EE instrument, the 5-min speech sample, to 55 mothers. The same instruments were utilized with the 54 controls and their mothers. Glycosylated hemoglobin A1 values were used as a measure of metabolic control. RESULTS: More than half of the children with diabetes (58.2%) had mild to moderate symptoms of anxiety or depression as compared to 9.3% of the controls. High EE was exhibited by 70.9% of the index group mothers in contrast to only 29.6% of the control group mothers. High maternal EE was not related to the psychopathology of children with diabetes. High maternal EE and in particular its EOI component and excessive detail (a subcategory of EOI) were related to poor metabolic control of the index children. CONCLUSIONS: Maternal EE is related to metabolic control in childhood diabetes; maternal EOI in particular is related to poor metabolic control. Mental health professionals should work with mothers of children with diabetes in an effort to modify such attitudes and emotions.

Adult↗
PubMed1984

Psychophysiological assessment of expressed emotion in schizophrenia. A case example.

Previous research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.

Adult↗
PubMed1975

[Experimental study of schizophrenia I. Cognitive structure of emotionally expressed voices (author's transl)].

The purpose of this study was to examine the cognitive structure of the schizophrenic patients. Two, one word sentence, "father" and "mother", with 15 different emotional expressions were given by both male and female announcers as verbal stimuli. Stimuli were judged by 29 normal students and 22 schizophrenic patients on 5 monopolar rating scales. Using both d-index and factor analysis, 4 factors were found. With Factor 1 no difference between the normals and the patients was found. With Factor 2 a little difference was found between the two, and with Factor 3 a great difference was found. Factor 4 was responded only by the normals. Considering the hypothesis states there are 2 stages in the cognition, the schizophrenic character was found on the second stage of the process where the reinterpretation of the information was made.

Adolescent↗
PubMedDate not supplied

[Human visual evoked potentials during the recognition of facial emotional expression].

Visual evoked potentials (VEPs) were recorded in 22 right-handed healthy subjects in the occipital, parietal, central, frontal and posterotemporal cortical areas during recognition and passive viewing of positive, negative, and neutral emotional facial expression. Peak latencies of N90, P150, and N180 VEP components appeared to be significantly shorter in response to the negative emotional expression than during administration of other facial stimuli. The differences were observed both during active recognition and passive viewing. Correct recognition was characterized by involvement of both hemispheres and high level of interhemispheric correlation between the peak latencies of P150 in the posterotemporal and of N180 in the frontal areas. It is suggested that the facial expressions are primarily recognized at the subthreshold level with participation of the posterotemporal areas. The role of the frontal areas is discussed in the completion of this process and making the correct decision about the image.

Adult↗
PubMed1988

Parental 'expressed emotion' as a predictor of schizophrenic relapse.

Fifty-seven schizophrenic patients were initially assessed after admission to hospital, at which time their parents completed a Camberwell Family Interview, generating "expressed emotion" (EE) scores. Relapse over the next nine months was not predicted by household EE status or by individual EE scales. Multivariate analyses suggested that a poor course after hospitalization was best predicted by a poor course before admission and by living in a one-parent household. High household EE status was a predictor only in one multivariate analysis after course of illness and one-parent household status had been entered, suggesting an interaction effect. We query the causal proposition linking high EE and relapse and suggest instead that a poor illness course may elicit high EE in relatives, particularly in one-parent households, and, thus, may make the principal contribution to the proposed link.

Adult↗
PubMed1995

Psychoeducation and expressed emotion in bipolar disorder: preliminary findings.

A multifamily psychoeducational intervention was carried out in patients with bipolar disorder. The study explored (1) the effects of the intervention on the level of expressed emotion (EE) of key relatives; (2) the validity of EE defined by a 5-min speech sample as a predictor of relapse; and (3) the evaluations of the intervention program by patients and key relatives. Four key relatives in the treatment group, compared with none in a waiting list control group, changed from high to low EE levels. The change was clinically but not statistically significant, perhaps because of the small sample size. Patients whose key relatives had low EE levels had a significantly lower number of relapses and hospital admissions compared with those whose key relatives had high EE levels. The psychoeducational program was well received by all participants, and there were no dropouts.

Bipolar Disorder↗
PubMed1993

Expressed emotion, social skill, and response to negative affect in schizophrenia.

The social skills and social perception of schizophrenia patients in response to negative affect was examined as a function of family expressed emotion (EE). Patients participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, patients with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but patients with highly critical relatives did not. Patients with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and patients during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. Patient ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between patients with high and low EE relatives. The results support the validity of the EE construct as an index of relatives' affective behavior and suggest that patients' social skills, such as assertiveness, may mediate negative affective exchanges in their families.

Adaptation, Psychological↗
PubMed1987

Expressed emotion and relapse in first episodes of schizophrenia. A rejoinder to Macmillan et al (1986).

Re-analyses of data presented by Macmillan et al (1986b) challenge their conclusions that high expressed emotion is not prognostically significant for the course of schizophrenia or unrelated to the level of behavioural disturbance prior to admission. Several equally plausible models of causal relationships between EE and duration of untreated illness are presented. We conclude that our re-analyses of the Macmillan data do not warrant premature closure regarding the significance of the EE variable.

Antipsychotic Agents↗
PubMed1995

Expressed emotion and subclinical psychopathology observable within the transactions between schizophrenic patients and their family members.

The authors examined whether young, recently discharged schizophrenic patients from high (n = 34) and low (n = 14) expressed emotion (EE) families differ in their level of subclinical symptomatology during a direct interaction task. Compared with patients from low-EE homes, patients from high-EE home showed significantly more odd and disruptive behavior with family members. High-EE relatives were more likely than low-EE relatives to respond with criticism to the first unusual thought verbalized by the patient; when this occurred, the probability of a second unusual thought was augmented. Results suggest that high-EE family members may display negative attitudes toward patients in part because they are exposed to higher levels of unusual or disruptive behavior than low-EE relatives. The data also support a bidirectional, transactional model of the relationship between relatives' EE and patients psychopathology.

Adolescent↗