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PubMed1989

Right-sided facial asymmetry in infant emotional expression.

In normal adults, emotional expressions tend to be more intense on the left side of the face, while in preschool-age children, no significant bias in facial asymmetry has been found. We examined facial asymmetries during smiling and distress in 59 infants studied longitudinally at 6.5, 10 and 13.5 months of age. In these infants, asymmetric expressions showed a bias toward greater intensity on the right side of the face. The study of infant facial expression may provide clues to the maturation of the cortical control of emotional responses.

Child Development↗
PubMed2003

The perceived expressed emotion in staff scale.

Recent research has highlighted the role of expressed emotion by ward staff in determining the well-being of psychiatric inpatients. Existing methods of assessing staff expressed emotion involve standardized interviews and are expensive and time-consuming. We report the development of a questionnaire measure of expressed emotion in staff as perceived by patients. In study 1, factor analysis of items administered to patients in a variety of settings led to the development of a questionnaire with three subscales: supportiveness, criticism and intrusiveness. In study 2, the test-retest reliability of the questionnaire was found to be adequate, and some evidence of concurrent validity for the scale was obtained against expressed emotion rated from staff speech samples. In study 3, the scale was shown to have good concurrent validity against the ward atmosphere scale, and scores were found to be independent of insight or experience of admission to hospital. The perceived expressed emotion in staff scale is a convenient measure, which may have utility for both research and clinical purposes.

Adult↗
PubMed1998

Expressed emotion and differentiation of self in the relatives of stable schizophrenia outpatients.

This study examined "trait" variables associated with high and low levels of expressed emotion in the parents of long-term stable schizophrenia outpatients. Self-descriptions collected from patients, their parents, and control participants matched to the parents were rated for levels of differentiation and integration, substantiality, relatedness, and self-criticism using established methods. The parents as a group did not differ from controls on any of the self-description variables. When parents were classified based on their expressed emotion status, those with low expressed emotion showed higher levels of differentiation and integration than those with high expressed emotion. Low expressed emotion parents were also lower on self-criticism. There was no difference between expressed emotion groups on substantiality or relatedness. These findings support the idea that high expressed emotion in parents of long-term stable outpatients may be a manifestation in part of relatively low levels of differentiation and integration of self in the parents. Furthermore, though patients as a group scored lower than parents on differentiation and integration and substantiality, patients' ratings on these two variables also correlated with those of their parents, suggesting that these variables are to some extent familially determined.

Adult↗
PubMed1994

Childhood emotional expressions, educational attainment, and age at onset of illness in schizophrenia.

This study examined the relation between preschizophrenic subjects' facial expressions of emotion in childhood home movies and two criterion variables: educational level (highest grade completed) and age at onset of illness. Earlier research suggest that premorbid affective blunting is associated with an earlier onset of illness and poorer prognosis in schizophrenia. It was, therefore, predicted that lower rates of both positive and negative facial expressions would be associated with lower levels of educational attainment and earlier age at onset of illness. The results indicated that childhood emotional expressions were not associated with educational level but were linked with age at onset. Preschizophrenic subjects who showed lower rates of negative emotion during late childhood/adolescence were younger at illness onset. Findings are discussed in light of previous reports linking affective symptoms with better prognosis in schizophrenia.

Adult↗
PubMed1993

Emotional expression and the reduction of motivated cognitive bias: evidence from cognitive dissonance and distancing from victims' paradigms.

Two experiments tested whether expression of emotions from which motivated cognitive biases presumably provide protection would reduce the extent of such biases. In Study I, we hypothesized that expressing any tension produced by writing a counterattitudinal essay would reduce the extent of dissonance-reducing attitude change. To test this hypothesis, Ss were induced to write an essay arguing for higher tuition. High-choice Ss were either encouraged to express their emotions, to suppress them, or to do neither. As expected, high-choice-express Ss exhibited the least attitude change. Study 2 tested the hypothesis that expressing fear of cancer would reduce the extent of defensive distancing from cancer patients, but expressing sympathy would not. Although control Ss clearly distanced from cancer patients, fear-expression Ss did not. Implications for understanding the role of affect in defense are discussed.

Adult↗
PubMed1994

Psychiatrists' ratings of expressed emotion.

The purpose of this study was to determine the extent to which psychiatrists are familiar with the concept of expressed emotion and to determine the extent of its use in their day-to-day practices. We also wished to test the ability of psychiatrists to estimate the expressed emotion status of the relatives of their patients. Following the assessment of expressed emotion in 96 relatives using the Camberwell Family Interview, the psychiatrists treating the schizophrenic patients were surveyed about their knowledge of expressed emotion and were asked to estimate the expressed emotion of their relatives. Thirty-five percent of the respondents use the expressed emotion concept daily in their practice. When the Camberwell Family Interview ratings of expressed emotion were compared with those from the psychiatrists, the agreement rate was no better than chance (45.7%). Without formal training in the use of the Camberwell Family Interview, practitioners are cautioned against ascribing an expressed emotion status to the relatives of their patients.

Adult↗
PubMed2005

A study of three measures of expressed emotion in a sample of Chinese families of a person with schizophrenia.

Emotional climate or expressed emotion (EE) has been examined in families of white descent who have a family member with schizophrenia but few studies have been conducted in Asian or Chinese families. This study tested the utility of the five-minute interview (FMI), adjective checklist (ACL) and family attitude scale (FAS) in a sample of Chinese family members in Beijing, in an attempt to introduce useful measures of EE into practice. A sample of 51 family members were interviewed and administered the three instruments. A total of 29.4% of families were found to be high-EE critical and 13.7% high-EE emotional over involvement using the FMI. The FAS and ACL prove internally consistent and were significantly correlated but not with the FMI. Cultural explanations for the discrepancies are offered. The measures have applicability in terms of understanding family relationships but further research and replication is necessary to deepen our understanding of EE in Chinese families.

Adaptation, Psychological↗
PubMed2003

Cardiovascular correlates of emotional expression and suppression: do content and gender context matter?

Three studies examined cardiovascular (CV) responses during emotional expression with empathically responsive strangers. Study 1 demonstrated that self-relevant emotional expression fostered CV reactivity consistent with challenge. Study 2 manipulated content of discussion by assigning participants to 1 of 4 conditions: emotional, nonemotional, emotional suppression, nonemotional suppression. In same-sex dyads. emotional expression elicited CV challenge reactivity whereas emotional suppression evoked CV threat reactivity, both compared with appropriate control groups. In opposite-sex dyads, however, emotional expression engendered CV threat. Because same- and opposite-sex disclosures differed, Study 3 controlled the content of emotional expression while manipulating gender context. Results confirmed findings from the first 2 studies, indicating that both context and content of emotional expression influenced CV effects. Findings are discussed within a theoretical challenge and threat perspective.

Adult↗
PubMed2003

Confirmatory factor analysis of the Family Emotional Involvement and Criticism Scale: evidence of the dimensionality of expressed emotion.

Using a convenience sample of 152 married couples, the present study tested models that alternately considered family members' perceptions of Expressed Emotion to be a one-, two-, three-, or four-factor construct as measured by the Family Emotional Involvement and Criticism Scale. Results of confirmatory factor analysis procedures indicated that perceptions of Expressed Emotion were best represented by a four-factor model that consisted of involvement, criticism, upset feelings, and approval. The methodological implications of these findings are discussed.

Adult↗
PubMed1999

The assessment of expressed emotion in a standardised family interview.

This study compared the expressed emotion (EE) scores obtained using individual interviews with parents with the scores obtained in whole family interviews. Interviews were carried out with 31 parents of 16 adolescents referred because of an eating disorder. There was moderate correlation of scores between the two interviews regarding critical comments, emotional overinvolvement, and warmth, but it was low for positive remarks. The study suggests that the whole family interview, which is time saving, is useful in assessing expressed emotion. The levels of expressed emotion, particularly the relatively low levels of critical comments and emotional overinvolvement, are similar to those of previous studies.

Adolescent↗
PubMed2003

Emotional expression and depth processing of trauma and their relation to long-term survival in patients with HIV/AIDS.

OBJECTIVE: This study examined the relationship between emotional expression and depth processing of trauma and long-term survival of patients living with AIDS. A further purpose was to examine the immune, health behavior and psychosocial correlates of emotional disclosure and depth processing. METHOD: Subjects wrote essays describing their reactions to past traumas; these were scored for emotional expression and depth processing (positive cognitive appraisal change, experiential involvement, self-esteem enhancement and adaptive coping strategies). Two HIV-seropositive groups were recruited for this study; long-term survivors (LTS; n=46) patients who had survived at least 4 years past a Category C (AIDS defining) symptom prior to starting protease inhibitors and an equivalent HIV-seropositive comparison group (ECOMP(LTS); n=89) who had CD4+ cells between 150 and 500, and had no history of Category C symptoms. The groups were equivalent on age, gender, ethnicity, education, employment, income, sexual orientation and route of infection. RESULTS: The group LTS were significantly higher than the ECOMP(LTS) group on emotional expression and depth processing. Depth processing mediated the relationship between emotional expression and long-term survival status. Depth processing was positively related to CD4+ cell number for women. Emotional expression was also significantly related to viral load (negatively) and to CD4+ cell number (positively) for women only. Interestingly, only depth processing (and not emotional expression) was related to medication adherence and to psychosocial variables (perceived stress and social support). CONCLUSIONS: Emotional expression and depth processing were related to long-term survival, however, depth processing was the mediator for this relationship and only depth processing was associated with medication adherence, perceived stress and social support. Our results underscore the importance of depth processing (and not just emotional expression) of traumatic experiences for people living with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Does emotional expression make a difference in reactions to breast cancer?

PURPOSE/OBJECTIVES: To examine the feasibility of using an emotional expression intervention with patients with cancer and test the hypothesis that emotional expression improves psychosocial adjustment. DESIGN: Sequentially randomized pretest/post-test design with repeated measures. SETTING: Two radiation therapy (RT) facilities. SAMPLE: Women completing RT for stage I or II breast cancer, who spoke and read English, were independent in self-care, and provided written consent. Subjects (N = 44) were middle-aged (mean = 53.6 years), Caucasian, married, and well educated. METHODS: Following a baseline interview, subjects were sequentially randomized to an attentional control group, a single dose, or a three-dose emotional expression writing group. Interventions were administered at the time of completion of RT. Follow-up telephone interviews were completed at 1, 4-6, 16, and 28 weeks post-RT. MAIN RESEARCH VARIABLES: Positive and negative affect, intrusiveness of thoughts, use of avoidant coping, side effect severity, trait negative affectivity, content of written essay, and themes derived from content analysis. FINDINGS: A high level of acceptance and completion of emotional expression existed, but no effect of the intervention on psychosocial adjustment was evident. Process measures in the three-dose group changed as expected. No relationship existed between content changes and outcome measures. CONCLUSIONS: Emotional expression is feasible for patients with cancer, but the efficacy of the intervention in improving mood and decreasing cognitive intrusion and avoidance was not supported. Emotional expression processes were consistent with those seen in other samples and may influence outcomes that were not addressed in this study. IMPLICATIONS FOR NURSING PRACTICE: More extensive testing is needed, including additional outcome variables. Essays reveal concerns around communication, recurrence, and health behavior changes that should be considered in practice.

Adult↗
PubMed2002

The uncharted waters of emotion: ethnicity, trait emotion and emotion expression in older adults.

Emotions are central to contemporary theories of health, and a growing body of psychological research has shown emotion and emotion regulatory styles to be predictive of health outcomes. Yet despite these clear links and the fact that patterns of emotion and expression are partially a product of culture, there is a meager literature on the emotional characteristics of different ethnic groups. Even where ethnicity has been investigated in emotions research, it has typically been operationalized in such a way that within-group differences are obscured with most individuals assigned to broad ethnic categories, such as non-Hispanic White, or Black. In the present study we draw on data from a multi-ethnic sample of 755 community-dwelling older adults to parse a picture of the emotional characteristics of three of the largest and most culturally distinct ethnic groups in the Northeastern United States: African Americans, West Indians (Jamaicans), and Eastern Slavs (Russians and Ukrainians) from the former Soviet Republic, as well as a comparison group of US-born European Americans. As predicted, there were striking differences in nine of 10 trait emotions as well as in levels of emotion expressed during conflict. The findings are discussed in terms of emotion socialization and implications for prediction and intervention in psychosocial models of emotions, emotion regulation, and health in older ethnic populations.

Journal Article↗
PubMedDate not supplied

The role of person familiarity in young infants' perception of emotional expressions.

This research investigated the role of person familiarity in the ability of 3.5-month-old infants to recognize emotional expressions. Infants (N = 72) were presented simultaneously with two filmed facial expressions, happy and sad, accompanied by a single vocal expression that was concordant with one of the two facial expressions. Infants' looking preferences and facial expressions were coded. Results indicated that when the emotional expressions were portrayed by each infant's own mother, infants looked significantly longer toward the facial expressions that were accompanied by affectively matching vocal expressions. Infants who were presented with emotional expressions of an unfamiliar woman did not. Even when a brief delay was inserted between the presentation of facial and vocal expressions, infants who were presented with emotional expressions of their own mothers looked longer at the facial expression that was sound specified, indicating that some factor other than temporal synchrony guided their looking preferences. When infants viewed the films of their own mothers, they were more interactive and expressed more positive and less negative affect. Moreover, infants produced a greater number of full and bright smiles when the sound-specified emotion was "happy," and particularly when they viewed the happy expressions of their own mothers. The average duration of negative affect was significantly longer for infants who observed the unfamiliar woman than for those who observed their own mothers. These results show that when more contextual information-that is, person familiarity-was available, infants as young as 3.5 months of age recognized happy and sad expressions. These findings suggest that in the early stages of development, infants are sensitive to contextual information that potentially facilitates some of the meaning of others' emotional expressions.

Affect↗
PubMed1996

Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview.

High expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2-3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3-4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.

Adult↗
PubMed1997

Liking, arousal potential, and the emotions expressed by music.

Previous research indicates that the specific emotions expressed by stimuli may be closely associated with their pleasing and arousing qualities, and this parallels psychomusicological research on the relationship between these two stimulus qualities. In light of this, the present research contends that the emotions expressed by musical stimuli are associated with their pleasing and arousing qualities. Sixty subjects rated 32 musical excerpts on 11-point scales representing the expression of eight specific emotions. Statistical analyses showed that these emotion ratings were predictable on the basis of 60 additional subjects' ratings of each excerpt in terms of 'liking' and 'arousal potential'. This indicates that ratings of liking and arousal potential are essentially similar to ratings of the specific emotions expressed by musical stimuli. These results are discussed in terms of the relationship between liking and arousal potential, and the implications that this may have for research on affective processes.

Adolescent↗
PubMed2003

Modulation of focused attention by faces expressing emotion: evidence from flanker tasks.

Three experiments evaluated whether facial expression can modulate the allocation of focused attention. Identification of emotionally expressive target faces was typically faster when they were flanked by identical (compatible) faces compared with when they were flanked by different (incompatible) faces. This flanker compatibility effect was significantly smaller when target faces expressed negative compared with positive emotion (see Experiment 1A); however, when the faces were altered to disrupt emotional expression, yet retain feature differences, equal flanker compatibility effects were observed (see Experiment 1B). The flanker-compatibility effect was also found to be smaller for negative target faces compared compatibility with neutral target faces, and for both negative and neutral target faces compared with positive target faces (see Experiment 2). These results suggest that the constriction of attention is influenced by facial expressions of emotion.

Adult↗