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PubMed1995

Induction of depressed and elated mood by music influences the perception of facial emotional expressions in healthy subjects.

The judgement of healthy subject rating the emotional expressions of a set of schematic drawn faces is validated (study 1) to examine the relationship between mood (depressed/elated) and judgement of emotional expressions of these faces (study 2). Study 1: 30 healthy subjects judged 12 faces with respect to the emotions they express (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation). It was found that a particular face could reflect various emotions. All eight emotions were reflected in the set of faces and the emotions were consensually judged. Moreover, gender differences in judgement could be established. Study 2: In a cross-over design, 24 healthy subjects judged the faces after listening to depressing or elating music. The faces were subdivided in six 'ambiguous' faces (i.e., expressing similar amounts of positive and negative emotions) and six 'clear' faces (i.e., faces showing a preponderance of positive or negative emotions). In addition, these two types of faces were distinguished with respect to the intensity of emotions they express. 11 subjects who showed substantial differences in experienced depression after listening to the music were selected for further analysis. It was found that, when feeling more depressed, the subjects perceived more rejection/sadness in ambiguous faces (displaying less intensive emotions) and less invitation/happiness in clear faces. In addition, subjects saw more fear in clear faces that express less intensive emotions. Hence, results show a depression-related negative bias in the perception of facial displays.

Acoustic Stimulation↗
PubMed1999

A longitudinal study of emotion expression and personality relations in early development.

To investigate emotion expression and personality relations, the authors coded infants' full-face and component positive and negative expressions during Episodes 4 through 8 of the strange situation procedure at age 18 months and obtained maternal ratings of the 5-factor model of personality when children were 3.5 years old. Full-face negative expression was directly related to Neuroticism and inversely related to Agreeableness and Conscientiousness. By contrast, component positive expression showed the exact opposite pattern of relations. Full-face positive expression was positively correlated with Extraversion and Openness to Experience. These findings indicate that full-face and component expressions may index different intensities of emotions. Emotion expression and personality relations were not mediated by the security of attachment continuum or the emotional reactivity dichotomy derived from the attachment subclassifications.

Age Factors↗
PubMed1990

Expressed emotion and psychosocial intervention: a review.

For thirty years research has been consistently demonstrating the validity of the concept of 'High Expressed Emotion' (HEE). After early pioneering work by Brown it was established that environmental influences, particularly, the emotion expressed by relatives to sufferers of schizophrenia, are strongly implicated in relapse. Consequently, the predictive validity of HEE has been revealed in a number of cross-cultural studies around the world. In addition, there is strong evidence from well designed intervention studies, that relapse, in schizophrenic clients living at home, can be prevented by the manipulation of social and environmental factors. The combined body of research that has now accumulated allows an hypothesis to be made about the aetiology of the illness, schizophrenia, itself. This theory has been described as the 'stress vulnerability' model. The paper concludes that psychosocial intervention strategies are effective but that, unfortunately, to date, their application has been mostly restricted to the intervention studies themselves.

Cross-Cultural Comparison↗
PubMed2005

Attention modulates the processing of emotional expression triggered by foveal faces.

To investigate whether the processing of emotional expression for faces presented within foveal vision is modulated by spatial attention, event-related potentials (ERPs) were recorded in response to stimulus arrays containing one fearful or neutral face at fixation, which was flanked by a pair of peripheral bilateral lines. When attention was focused on the central face, an enhanced positivity was elicited by fearful as compared to neutral faces. This effect started at 160 ms post-stimulus, and remained present for the remainder of the 700 ms analysis interval. When attention was directed away from the face towards the line pair, the initial phase of this emotional positivity remained present, but emotional expression effects beyond 220 ms post-stimulus were completely eliminated. These results demonstrate that when faces are presented foveally, the initial rapid stage of emotional expression processing is unaffected by attention. In contrast, attentional task instructions are effective in inhibiting later, more controlled stages of expression analysis.

Adolescent↗
PubMed2005

Gender, neuroticism, and emotional expressivity: effects on spousal constraints among individuals with cancer.

The authors prospectively tested the hypothesis that emotional expressivity would moderate the predictive relationship between patient neuroticism and spousal constraints among 120 individuals with cancer. The authors also examined whether patient gender further moderated the hypothesized relationships. After we controlled for Time 1 constraints, results revealed a significant emotional Expressivity x Neuroticism effect on Time 2 spousal constraints. This moderator effect was qualified by a significant Gender x Emotional Expressivity x Neuroticism effect, such that neuroticism predicted the greatest levels of spousal constraints among female but not male patients reporting higher levels of emotional expressivity. Thus, female, but not male, patients who report the tendency to both experience and express high levels of distress appear most likely to trigger constraints from their spouses.

Affect↗
PubMed2000

Emotionally expressive coping predicts psychological and physical adjustment to breast cancer.

This study tested the hypothesis that coping through emotional approach, which involves actively processing and expressing emotions, enhances adjustment and health status for breast cancer patients. Patients (n = 92) completed measures within 20 weeks following medical treatment and 3 months later. Women who, at study entry, coped through expressing emotions surrounding cancer had fewer medical appointments for cancer-related morbidities, enhanced physical health and vigor, and decreased distress during the next 3 months compared with those low in emotional expression, with age, other coping strategy scores, and initial levels on dependent variables (except medical visits) controlled statistically. Expressive coping also was related to improved quality of life for those who perceived their social contexts as highly receptive. Coping through emotional processing was related to one index of greater distress over time. Analyses including dispositional hope suggested that expressive coping may serve as a successful vehicle for goal pursuit.

Adaptation, Psychological↗
PubMed1996

Relationship of expressed emotion with relapse of schizophrenia patients in Kelantan.

The families of 83 schizophrenic patients were studied to find out the level of expressed emotion in them leading to the relapse of these patients. The patients were having more than two episodes of schizophrenia (DSM-III-R). The most salient finding was the virtual absence of high level of expressed emotion as the cause of relapse. It was found that the majority of the families (72.3%) had low expressed emotion while only 25.3% had high expressed emotion and only 2.4% families were equivocal in this respect. This finding is in contrast with various other findings in this area. The most likely explanation for this disagreement is the cultural differences between Malaysian patients and Western patients.

Culture↗
PubMed2000

Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems.

Expressed Emotion (EE), a measure of the emotional climate of the family, predicts subsequent adjustment of adults with mental disorder (Leff & Vaughn, 1985). Despite the acknowledged importance of the family in childhood disorders, there have been relatively few studies of expressed emotion with adolescents and school-aged children and virtually none focused on preschoolers. The present study utilized the Five Minute Speech Sample (FMSS) to examine how Expressed Emotion relates concurrently and longitudinally to child problem status in a community sample of 112 preschool-aged children. At preschool, the proportion of high EE increased significantly across three child groups: Comparison (8.1%), Borderline Problem (15.8%), and High Problem (41.2%); however, preschool EE was not predictive of subsequent child status at 1st grade. Expanded FMSS codes. tapping positive affect and worry about the child, were also related to child problem group at preschool and were predictive of subsequent child status at 1st grade. Because parents' stress and adjustment were also highly related to child problem group status, we examined whether the FMSS codes were essentially a proxy for these or whether they explained unique variance. In two stepwise regressions on preschool child group status (divided by total problems and by externalizing problems), maternal stress was the only variable to enter. Also, in predicting to 1st grade externalizing child group status, only maternal stress entered. Discussion focused on the extension of the EE construct and other FMSS coding to young children, and the need to recognize that to some extent these variables may reflect maternal stress and adjustment.

Adult↗
PubMed2005

Posed prosodic emotional expression in unilateral stroke patients: recovery, lesion location, and emotional perception.

Recovery of emotional functioning following stroke has received limited attention in the neuropsychological literature. By emotional functioning, we refer to a range of processing modes, including perception, expression, experience, and behavior. The aim of the current study was to evaluate the course of prosodic emotional expression over time in individuals with stroke. Posed prosodic expression tasks from the New York Emotion Battery were administered to right brain-damaged (RBD), left brain-damaged (LBD), and demographically matched normal control (NC) participants at two separate testing times (median interval of 25 months). Posers (i.e., individuals producing the emotional expressions) were required to produce neutral-content sentences using four different emotional tones (happiness, sadness, anger, and fear). Raters judged poser output for accuracy, intensity, and confidence. For accuracy ratings, RBDs and LBDs were impaired relative to NCs at baseline. In terms of recovery, there was a tendency for LBDs to improve over time, and there was a significant decline for RBDs. Inspection of the group mean data suggested that frontal lesions had a negative impact on prosodic emotional expression in RBDs and that lesion extent did not systematically influence performance at baseline or over time. Participants maintained their relative standing on the NYEB expression tasks over time. Finally, no significant relationships were found between participant performance on prosodic emotional perception and expression tasks at either testing time, suggesting that these two processing modes are relatively independent.

Aged↗
PubMed2005

Familiarity and emotional expression influence an early stage of face processing: an electrophysiological study.

Recent data indicate that the familiarity and the emotional expression of faces occur at an early stage of information processing. The goal of the present study was to determine whether these two aspects interact at the structural encoding stage as reflected by the N170 component of event-related potentials in tasks requiring the subjects either to identify whether the faces were familiar or the nature of the emotional expression. The results indicate that the neural responses to level of familiarity and emotional expression were observable at this early processing stage but without interacting. In particular, faces of personal importance to the subjects differed from those of less personal importance. Because familiarity did not interact with emotional expression at behavioral and electrophysiologic levels, our results support the contention of parallel and independent processing of faces.

Adult↗
PubMed2004

Expressed emotion in multiple subsystems of the families of toddlers with depressed mothers.

Expressed emotion was examined in families of toddlers (N = 101) whose mothers had experienced major depressive disorder occurring since the child's birth, and contrasted with expressed emotion in demographically comparable families (N = 54) with no history of parental mental disorder to elucidate family systems processes as contributors to child functioning. Both mothers and fathers provided Five-Minute Speech Samples on their child, their spouse, and themselves, and completed measures of marital adjustment, trait affect, relationship quality with their own parents in childhood, and child behavior problems. Maternal-expressed emotion criticism regarding child, self, and spouse was higher in the families with depressed mothers; paternal criticism regarding self and spouse also was higher in the depressed families. Mothers and fathers in the depressed group also differed on relational/ affective features, exhibiting lower marital satisfaction, higher trait negative affect, and more negative childhood relationship representations, relative to the nondepressed group, and mothers reported more child behavior problems. Mediational models were evaluated separately for the different targets of maternal and paternal criticism and child behavior problems, and findings supported both individual parent and spouse contributions as mediators of the relation between depression group status and expressed criticism and child behavior problems. The findings are discussed in terms of the multiple levels of family system influence on negativity in the emotional environment of toddlers of depressed mothers, developmental risk, and the need for family-level interventions.

Adult↗
PubMed2006

Ethnicity, expressed emotion, and schizophrenia patients' perceptions of their family members' criticism.

Expressed emotion is a widely researched construct. However, less is known about patients' own perceptions of their relatives' expressed emotion. Using a sample of 42 patient/family member dyads with schizophrenia, we examined the concordance between the number of criticisms expressed by relatives during the Camberwell Family Interview and patients' perceptions of how critical they perceived their relative to be. As predicted, white and Latino family members who expressed more criticism during the Camberwell Family Interview were indeed perceived as more critical by patients. Among blacks, however, no significant association was found between relatives' expressed criticism and patients' perceptions of their relatives' criticism. Findings from this study suggest that cultural/ethnic values may influence how criticism from relatives is perceived and experienced by patients.

Adult↗
PubMed1992

Attributions of symptomatology: an exploration of family factors associated with expressed emotion.

This study explored family factors associated with Expressed Emotion (EE) in families with a member diagnosed with schizophrenia. Drawing on an attributional model of expressed emotion it was predicted that high EE relatives would have less knowledge of the illness and would attribute negative symptoms to the personality, rather than the illness, of the sufferer. Thirty-one caregivers of schizophrenic patients were interviewed. Results indicated that EE status was related to knowledge, coping and causal attributions of negative symptoms. Low EEs, as compared with High EEs, tended to have more knowledge of the illness and to cope better with the patient, and were less likely to attribute the cause of negative symptoms to the sufferer's personality. Support was therefore obtained for the utility of an attributional model in attempting to understand the determinants of levels of EE.

Activities of Daily Living↗
PubMed1981

The role of maintenance therapy and relatives' expressed emotion in relapse of schizophrenia: a two-year follow-up.

A two-year follow-up study was conducted, mainly from case notes, of patients who had originally taken part in a study of the influence of relatives expressed emotion on schizophrenic relapse. It was found that in the two years following discharge from hospital patients from high expressed emotion homes had a significantly greater relapse rate than those from low expressed emotion homes. The prophylactic effect of maintenance drugs was no longer evident for patients from high expressed emotion homes at the two-year follow-up. By contrast, a significant protective effect of maintenance therapy emerged for patients from low expressed emotion homes. The interpretation of these findings is discussed.

Attitude to Health↗
PubMed2002

Adult sibling expressed emotion and fellow sibling deviance: a new piece of the family process puzzle.

Seventy-three older siblings were assessed in early adulthood with the Five-Minute Speech Sample (FMSS) measure of expressed emotion. Sibling critical expressed emotion was linked with younger brother concomitant and future antisocial behavior, substance use, deviant peer association, increased rate of criminal arrests, and early onset sexual activity. Siblings of younger brothers with behavior problems were also more likely to be critical of, and to report negative relationships with, these brothers than were siblings of well-adjusted brothers. Sibling critical expressed emotion also predicted younger brothers' maladjustment 1-2 years later, after controlling for earlier sibling conflict and parent discipline. The findings accentuate the importance of understanding the influence of intrafamilial processes in the etiology of behavior problems.

Adult↗
PubMed2006

Emotionally expressive coping reduces pregnancy rates in patients undergoing in vitro fertilization.

OBJECTIVE: To examine the effects of coping and of infertility-specific and nonspecific stress on pregnancy outcomes after IVF treatment. DESIGN: Cross-sectional design controlling for potential confounding variables. Psychosocial measures were assessed on the day of embryo transfer. SETTING: Fertility clinic in Greece. PATIENT(S): Three hundred forty-two women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A clinically recognized pregnancy or a biochemical pregnancy. RESULT(S): Of 342 women participating in the study, 79 became pregnant, representing a success rate of 23.3%. There were no statistically significant differences between women who became pregnant and those who did not in terms of duration of infertility, causes of infertility, previous IVF cycles, and infertility-specific or nonspecific stress. The only factor that was significantly associated with pregnancy outcome was emotionally expressive coping (adjusted odds ratio, 1.272; 95% confidence interval, 1.06-1.52). Women who coped by expressing their emotions were less likely to get pregnant than were women who did not. CONCLUSION(S): The link between psychological processes and reproductive outcomes of IVF treatment is less likely to be identified through the assessment of stress but rather is likely to be identified through the assessment of the strategies that people use to deal with stress. Emotionally expressive coping may be a risk factor for reduced pregnancy rates in women undergoing IVF.

Adaptation, Psychological↗
PubMedDate not supplied

High expressed emotion: marker for a caring family?

"Expressed emotion" (EE) is considered a marker of dysfunctional family interaction in patients with schizophrenia. An alternative hypothesis, however, is that at least some of the different elements of EE really represent attempts on the part of carers to cope with and care for a relative with a psychiatric disorder. EE (criticism and emotional overinvolvement) was measured in relatives (n = 31) of patients with psychotic illness using the Five-Minute Speech Sample (FMSS). Level of EE was examined in relation to (1) patient-reported family involvement in care over the previous 2 years as indicated by medication monitoring, involvement in treatment decisions, and providing a substitute for institutional care; and (2) symptom severity and number of psychotic episodes. Presence of EE in the relative was strongly associated with the degree of family involvement in care (odds ratio [OR] over three levels: 3.2; 95% confidence interval [CI], 1.1 to 9.0). In addition, presence of high EE was associated with number of psychotic episodes in the previous 5 years in the proband (OR over 0, 1, or 2 episodes: 6.2; 95% CI, 1.2 to 31.9). The association with family involvement was confined to emotional overinvolvement (OR = 9.1; 95% CI, 2.0 to 42.2), whereas the association with previous psychotic episodes was confined to criticism (OR = 20.6; 95% CI, 2.8 to 149.3). Emotional overinvolvement may be a state marker for attempts on the part of relatives to be partners in the care for patients with psychotic illness. High level of criticism may be a trait marker in relatives associated with poor prognosis, but could also develop in reaction to a frequently relapsing illness.

Caregivers↗
PubMed2003

Conflict over emotional expression: implications for interpersonal communication.

The current study examined the role of conflict over emotional expression for subjective and interpersonal functioning. The Ambivalence Over the Expression of Emotion Questionnaire (AEQ) was administered to female students who were videotaped while engaging in a conflict-resolution and feedback task with their boyfriends. External ratings showed ambivalent women to be less positive in their verbal statements and to be more constricted in their nonverbal expressions. When mood and other personality constructs were controlled for, ambivalence entailed greater overt submissiveness. Ambivalent women also displayed lower congruence between their verbal and nonverbal communication, irrespective of depression and other personality variables. These data suggest that conflict over emotional expression entails less congruent communication, less positivity in close relationships, and a subordinate stance for the ambivalent individual.

Communication↗