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PubMed2002

Expressed emotion: a review of assessment instruments.

Expressed emotion (EE) refers to the quality of the emotional climate between a relative and a family member with a serious psychiatric disorder. Well-established, it has proven to be a reliable predictor of the relapse rate of psychiatric patients. In this article, the Camberwell Family Interview (CFI), the standard instrument, and 11 alternative EE measures will be presented and discussed with regard to their psychometric properties. It is concluded that the CFI remains the best instrument for assessing the quality of the relationship.

Expressed Emotion↗
PubMed2001

The relations of parental emotional expressivity with quality of Indonesian children's social functioning.

In Western societies, parental expression of positive emotion has been positively related to the quality of children's social functioning, whereas their expression of negative emotion has been negatively or inconsistently related. The relations of parental expressivity to 3rd-grade Indonesian children's dispositional regulation, socially appropriate behavior, popularity, and sympathy were examined. Parents, teachers, and peers reported on children's social functioning and regulation, and parents (mostly mothers) reported on their own expression of emotion in the family. Generally, parental expression of negative emotion was negatively related to the quality of children's social functioning, and regression analyses indicated that the relations of parental negative expressivity to children's popularity and externalizing behaviors might be indirect through their effects on children's regulation. Unexpectedly, parental expression of positive emotion was unrelated to children's social functioning.

Adult↗
PubMed1988

Infant discrimination of naturalistic emotional expressions: the role of face and voice.

The ability of infants to discriminate dynamic, multimodal expressions of emotion was assessed in a series of 5 experiments. In Experiment 1, 48 infants of 4 and 5 months (total N = 96) were habituated to color/sound videotapes of 6 women speaking the same script sadly or happily. Following habituation, 2 new women were presented, each speaking once in the familiarized emotion and once in the novel emotion. Order of stimulus presentation (Sad----Happy, Happy----Sad) was counterbalanced. 5-month-olds were able to discriminate the expressions in both directions, whereas 4-month-olds could discriminate them only in the Sad----Happy direction. In Experiment 2, the ability of 5- and 7-month-olds to discriminate happy and angry expressions was examined using the Happy----Angry stimulus order alone. Only the 7-month-olds could differentiate these stimuli. In Experiment 3, it was shown that 7-month-olds could not distinguish these same Happy----Angry stimuli without vocal accompaniment. The purpose of the fourth experiment was to determine whether the voice played an equally important role in the Sad----Happy discrimination of Experiment 1. Surprisingly, a 5-month group tested without voice readily discriminated these stimuli. Finally, the fifth experiment sought to determine whether an Angry----Happy comparison might also be discriminable without voice. A 7-month group tested in this manner could not discriminate these expressions, while a group tested with voice could. The results indicate that infants can differentiate dynamic, multimodal expressions as early as 5 months, that they distinguish dynamically distinct expressions earlier than more similarly animated expressions, and that they seem to rely more on the voice than the face in making these discriminations.

Age Factors↗
PubMed2000

Maternal expressed emotion related to attachment disorganization in early childhood: a preliminary report.

Using a longitudinal sample of children, this study examined the relation between maternal Expressed Emotion (EE) and mother-child attachment disorganization at age 6 years. A nonclinical sample of 33 children (at ages 12 months and 18 months) from Berlin, Germany participated with their mothers in Ainsworth's Strange Situation. Thirty-two children were again observed with their mothers at age 6 years in a standard laboratory attachment observation. At the time of the 6-year assessment, maternal EE was assessed based on a Five-Minute Speech Sample. Mothers also completed the Life Events Questionnaire, a measure of family stress, and the Present State Examination, a measure of maternal depression. Maternal Expressed Emotion was significantly linked to mother-child attachment security at age 6 years. Further analyses revealed that High EE was most closely linked to the disorganized attachment pattern at age 6 years, an at-risk attachment pattern that has been associated with intrusive and hostile maternal behavior. The relationship was upheld when other relevant variables, including infant attachment disorganization and a measure of perceived family stress, were simultaneously considered. The study provides independent validation of Expressed Emotion as a measure of relationship quality in early childhood. It also provides a basis for the further investigation of the nature of the relation between maternal Expressed Emotion and attachment disorganization.

Adult↗
PubMed1998

Guilt proneness and expressed emotion in relatives of patients with schizophrenia or related psychoses.

OBJECTIVE: Knowledge of what predicts relatives' expressed emotion (EE) may contribute to improved family work in schizophrenia. In the present study we examined guilt proneness as a determinant of EE components. METHOD: In a Norwegian sample of 46 recently hospitalized patients (schizophrenia or schizophreniform disorder) and 69 relatives, relatives' expressed emotion was assessed by means of the Camberwell Family Interview, and guilt proneness by means of the Revised Mosher Guilt Inventory. (RMGI). RESULTS: Confirmatory multiple regression analyses showed that hostility-guilt (RMGI) was negatively related to high levels of criticism and hostility and, for men, positively related to emotional overinvolvement. There was a strong positive relationship between relatives' guilty conscience (RMGI) and emotional overinvolvement if the patient had a diagnosis of schizophrenia. CONCLUSIONS: Our analyses indicate that relatives' guilt proneness may be a determinant of their criticism, hostility and emotional overinvolvement towards a schizophrenic family member. This personality trait should be taken into account in family work which aims at modifying relatives' expressed emotion.

Adolescent↗
PubMedDate not supplied

Relationship between visual evoked potentials and subjective differences between emotional expressions in "face diagrams".

The relationship between visual evoked potentials resulting from substitution of one image of a human "face diagram" for another and assessment of perceived differences between the emotional expressions of these faces were studied. Emotions were altered by changing the curvature of the mouth and/or the slope of the brows. Unlike the traditional approach, in which visual evoked potentials are recorded in response to presentation of a single stimulus bearing a face image, visual evoked potentials in the present study were recorded as the response to instantaneous substitution of a reference stimulus with a test stimulus, and thus represented the direct response to the difference between the stimuli. A characteristic of this approach was the use of a series of functionally associated test stimuli, in which there was a monotonic increase in the difference between the test and references images in terms of the variable characteristics of the stimuli. Analysis revealed differences in the amplitudes of the P120, N180, and P230 peaks in leads O1, O2, P3, P4, T5, and T6, which demonstrated high levels of correlation both with a points-scale assessment of perceived differences between the emotional expressions of faces and with the physical (configurative) differences between images of the same faces as defined by the differences in the orientation angles of lines determining mouth curvature and brow angle. Responses were seen to differences between stimuli for both types of change in pairs of images, both going from reference image to test image and from test image to reference image. Changes in the interpeak amplitude of the P120-N180 potential in the temporal areas of both hemispheres provided the earliest electrophysiological measure of perceived differences between the emotional expressions of human faces. This suggests application of the spherical model for the perception of emotions to specify emotional facial expressions in terms of the activity of line orientation detectors.

Electroencephalography↗
PubMed2004

Expressed emotion in family members of depressed older adults.

This study examined similarities between the Expressed Emotion (EE) construct developed in the psychiatric literature and interpersonally relevant constructs derived from gerontology caregiver research. Expressed emotion and other indices derived from the Camberwell Family Interview (CFI) were assessed in 46 adult children and spouses providing care to an older adult hospitalized for major depressive disorder. The relationship of CFI indices with the family member's past and current relationship with the depressed relative, illness attributions, and emotional functioning was examined. Of the family members, 60.9% were classified as high EE. Measures of past and current relationship and illness attributions were significantly associated with most of the CFI indices. In multivariate analyses, past relationship and illness attributions predicted high EE status. Only past relationship predicted the CFI index of warmth. There is conceptual and empirical overlap between the EE construct and interpersonally relevant gerontology variables. Expressed emotion holds promise for a more complex understanding of caregiving and better caregiver interventions.

Affect↗
PubMed1984

Expressed emotion and social networks of parents of schizophrenic patients.

This study considered the relationship between the personal networks of parents of schizophrenic patients and ratings of their level of expressed emotion towards the patient. Our initial hypothesis was that parents with high expressed emotion would be more isolated from an effective social support system. We found that the size of parental networks did correlate with the length of the patient's illness, with smaller networks associated with longer illnesses. There was no connection between overall ratings of parental expressed emotion and the size or quality of their social networks. However, the raw score of one component of expressed emotion, emotional over-involvement, did correlate with several network variables, indicating that parents who are over-involved with the patient are also more involved with their networks rather than being isolated.

Adolescent↗
PubMed2003

Face-selective processing and the effect of pleasant and unpleasant emotional expressions on ERP correlates.

Previous studies have revealed that decoding of facial-expressions starts very early in the brain ( approximately 180 ms post-stimulus) and might be processed separately from the basic stage of face perception. In order to explore brain potentials (ERPs) related to decoding of facial-expressions and the effect of emotional valence of the stimulus, we analyzed 18 normal subjects. Faces with five basic emotional expressions (fear, anger, surprise, happiness, sadness) and neutral stimulus were presented in random order. The results demonstrated that an emotional face elicited a negative peak at approximately 230 ms (N230), distributed mainly over the posterior site for each emotion. The electrophysiological activity observed may represent specific cognitive processing underlying the decoding of emotional facial-expressions. Nevertheless, differences in peak amplitude were observed for high-arousal negative expressions compared with positive (happiness) and low-arousal expressions (sadness). N230 amplitude increased in response to anger, fear and surprise, suggesting that subjects' ERP variations are affected by experienced emotional intensity, related to arousal and unpleasant value of the stimulus.

Adult↗
PubMed2004

Emotional expressiveness and neuroticism: do they predict marital quality?

This study examines how neuroticism and emotional expressiveness relate to perceptions of marital quality. Data were gathered from a sample of 197 Israeli couples. Wives scored higher than husbands on neuroticism and emotional expressiveness, but no significant gender differences were found in perceived marital quality. Structural equation models were estimated to examine the effect of both spouses' neuroticism and expressiveness on their own and on their spouse's evaluation of marital quality. Neuroticism was a strong predictor of both spouses' perceived marital quality. Wives' perceived marital quality was positively associated with both their own and their husbands' emotional expressiveness. In contrast, husbands' perceived marital quality was associated neither with their own nor with their wives' expressiveness.

Affect↗
PubMed2006

Self-report and linguistic indicators of emotional expression in narratives as predictors of adjustment to cancer.

Emotional expression and cognitive efforts to adapt to cancer have been linked to better psychological adjustment. However, little is known about the relationship between linguistic indicators of emotional and cognitive coping efforts and corresponding self-report measures of related constructs. In this study, we sought to evaluate the interrelationships between self-reports of emotional suppression and linguistic indicators of emotional and cognitive coping efforts in those living with cancer. Seventy-one individuals attending a community cancer support group completed measures of emotional suppression and mood disturbance and provided a written narrative describing their cancer experience. Self-reports of emotional suppression were associated with more rather than less distress. Although linguistic indicators of both emotional expression and cognitive processing were generally uncorrelated with self-report measures of emotional suppression and mood disturbance, a significant interaction was observed between emotional suppression and use of cognitive words on mood disturbance. Among those using higher levels of emotional suppression, increasing use of cognitive words was associated with greater levels of mood disturbance. These findings have implications for a) the therapeutic use of emotion in psychosocial interventions and b) the use of computer-assisted technologies to conduct content analysis.

Adaptation, Psychological↗
PubMed2005

Aging holocaust survivors' well-being and adjustment: associations with ambivalence over emotional expression.

A sample of 90 older respondents (age range: 78-83 years) composed of 2 Holocaust groups (camp inmates and other survivors) and a comparison group completed questionnaires measuring ambivalence over emotional expression, positive and negative affect, and psychosocial adjustment. The Holocaust groups rated higher than the comparison group on negative affect and ambivalence over emotional expression and lower on psychosocial adjustment. Ambivalence over emotional expression mediated the effects of the Holocaust on negative affect. These data suggest that the effects of the Holocaust are evident 60 years later, highlighting the role of ambivalence over emotional expression in the well-being of Holocaust survivors.

Adaptation, Psychological↗
PubMed1994

Maternal expressed emotion in conduct and emotional disorders of childhood.

Maternal expressed emotion (EE) scales were rated for children aged 6-11 with conduct disorders, emotional disorders and a group of non-referred children matched for sex and age (N = 30 in each of the three groups). Maternal warmth distinguished significantly between the three groups (CD < ED < Controls), while criticism distinguished the group of conduct disordered children. Maternal criticism was positively associated with child behaviour ratings even within the non-referred group. These observational ratings of warmth and criticism were found to be much more strongly associated with child behaviour than maternal ratings of their family environment.

Adult↗
PubMed1994

The clinical utility of expressed emotion in schizophrenia.

The measure expressed emotion (EE) has been developed over the course of the last 35 years, but it is only over the last decade that there has been an explosion of interest in it. It taps attitudes and behaviour in those who care for people with a range of psychiatric and physical conditions. It has been the basis for successful studies of psychosocial intervention in schizophrenia. However, several questions remain to be answered concerning EE. This article summarizes the results of an aggregate analysis of 25 studies of EE, which appears to be a robust predictor of relapse, in a range of locations and cultures, and in both sexes. Medication and family atmosphere exert effects on relapse that are completely independent. High contact with high-EE relatives increases relapse rates still further, while if anything contact with low-EE relatives is protective. We describe what is known about the relationship of EE with the behaviour of patients and carers. It is now clear that staff members can exhibit the same range of behaviours as the relatives of sufferers. Finally, we set out the implications for the routine management of people with longstanding schizophrenia.

Chronic Disease↗
PubMed2001

Peekaboo: a new look at infants' perception of emotion expressions.

Infants' responsiveness to others' affective expressions was investigated in the context of a peekaboo game. Forty 4-month-olds participated in a peekaboo game in which the typical happy/surprised expression was systematically replaced with a different emotion, depending on group assignment. Infants viewed three typical peekaboo trials followed by a change (anger, fear, or sadness) or no-change (happiness/surprise) trial, repeated over two blocks. Infants' looking time and affective responsiveness were measured. Results revealed differential patterns of visual attention and affective responsiveness to each emotion. These results underscore the importance of contextual information for facilitating recognition of emotion expressions as well as the efficacy of using converging measures to assess such understanding. Infants as young as 4 months appear to discriminate and respond in meaningful ways to others' emotion expressions.

Discrimination, Psychological↗
PubMed1985

Relation of ineffective communication of emotion and children's recognition of emotional expressions.

The relationship of discrepancies found in parents' appraisals of emotion and children's abilities to discriminate emotional expressions was examined among 92 6- to 6 1/2-yr.-old kindergarten girls and their parents. Results supported the supposition that the discrepancies in parents' appraisals of emotion could reflect ineffective communication of emotion within the family. Greater discrepancies of appraisals of emotion noted in parents were associated with weaker recognition of emotional expressions by their daughters. Families present children distorted methods of expressing and interpreting feelings and a model of discrepant and nongenuine social communication.

Child↗
PubMed2003

Emotional expressiveness and the quality of life of patients with schizophrenia.

BACKGROUND: The present research aims to study the association between emotional expressiveness of primary care-givers and quality of life of patients with schizophrenia. METHOD: The data for the present study were collected from 174 purposively selected patients with schizophrenia and their primary care-givers. The Quality of Life Interview (QOLI) (Lehman 1988) was used to collect information related to the quality of life of patients. The care-givers' emotional expressiveness was assessed using three questions on home environment from Disability Assessment Schedule (WHO/DAS) (WHO 1988). RESULTS: Three components of emotional expressiveness were included in the present research, namely, emotional involvement, control and attitude of rejection. Among these three components, emotional involvement of key care-givers was found to have a significant association with quality of life of schizophrenia patients. CONCLUSION: Based on this result, the present study argues that emotional involvement of key care-givers needs careful attention while planning psychosocial rehabilitation programmes aimed at enhancing the quality of life of schizophrenia patients.

Adult↗
PubMed1993

Factors affecting expressed emotion in parents of ill and normal children.

In order to examine their relationship to Expressed Emotion, family environment and marital relationships were measured in the parents of disruptive, obsessive-compulsive, and normal children. Satisfactory family and martial environment were found to be related to low Expressed Emotion, while achievement orientation in mothers and greater family conflict were found to be significantly related to high Expressed Emotion.

Adaptation, Psychological↗