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Expressed Emotion (expressed + emotion)

Distribution by Scientific Domains

Psychology	38%
Medical Sciences	38%
Humanities and Social Sciences	23%

Selected Abstracts

Cultural Variability in the Manifestation of Expressed Emotion

FAMILY PROCESS, Issue 2 2009
STEVEN R. LÓPEZ PH.D.
We examined the distribution of expressed emotion (EE) and its indices in a sample of 224 family caregivers of individuals with schizophrenia pooled from 5 studies, 3 reflecting a contemporary sample of Mexican Americans (MA 2000, N=126), 1 of an earlier study of Mexican Americans (MA 1980, N=44), and the other of an earlier study of Anglo Americans (AA, N=54). Chi-square and path analyses revealed no significant differences between the 2 MA samples in rates of high EE, critical comments, hostility, and emotional over-involvement (EOI). Only caregiver warmth differed for the 2 MA samples; MA 1980 had higher warmth than MA 2000. Significant differences were consistently found between the combined MA samples and the AA sample; AAs had higher rates of high EE, more critical comments, less warmth, less EOI, and a high EE profile comprised more of criticism/hostility. We also examined the relationship of proxy measures of acculturation among the MA 2000 sample. The findings support and extend Jenkins' earlier observations regarding the cultural variability of EE for Mexican Americans. Implications are discussed regarding the cross-cultural measurement of EE and the focus of family interventions. RESUMEN Examinamos la distribución de emoción expresada y sus índices en una muestra de 224 cuidadores parientes de personas con esquizofrenia tomadas de 5 estudios, tres que reflejaban una muestra contemporánea de personas méxico-estadounidenses (ME 2000, N=126), una de un estudio anterior de méxico-estadounidenses (ME 1980, N=44, Karno et al., 1987) y la otra de un estudio anterior de angloamericanos (AA, N=54, Vaughn et al., 1984). La distribución ji-cuadrado y los análisis de pautas no revelaron diferencias significativas entre las dos muestras de méxico-estadounidenses en cuanto a los índices de alta emoción expresada, comentarios críticos, hostilidad y sobreimplicación emocional. Solo la calidez de los cuidadores fue distinta en las dos muestras de méxico-estadounidenses; el grupo ME 1980 demostró mayor calidez que el grupo ME 2000. Se encontraron sistemáticamente diferencias considerables entre las dos muestras de méxico-estadounidenses y la muestra de angloamericanos; los angloamericanos demostraron índices más altos de alta emoción expresada, más comentarios críticos, menos calidez, menos sobreimplicación emocional y un perfil de alta emoción expresada compuesto mayormente por crítica y hostilidad. También examinamos la relación de los cálculos aproximados de aculturación entre la muestra ME 2000. Los resultados respaldan y amplían las observaciones anteriores de Jenkins (1991) con respecto a la variabilidad cultural de emoción expresada en los méxico-estadounidenses. Se comentan las implicaciones con respecto a la evaluación intercultural de emoción expresada y al enfoque de las intervenciones familiares. Palabras clave: Emoción expresada, cultura, méxico-estadounidenses, sobreimplicación emocional, esquizofrenia, cuidadores parientes [source]

Expressed Emotion about children: reliability and validity of a Camberwell Family Interview for Childhood (CFI-C)

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000
Adolescent Psychiatry, Stephen Scott Senior Lecturer in Child
Abstract A Camberwell Family Interview for Childhood (CFI-C) was developed by adding questions about the family impact of the child's problems to a semi-structured interview on child psychiatric symptoms. The whole CFI-C took under an hour to administer; the questions about family impact added 15,20 minutes. The inter-rater reliability was good (kappa 0.64,1.0). Mothers of 25 boys aged four to nine years referred with disruptive behaviour, and 25 matched controls were interviewed twice in five months. Test-retest stability was fair to good (kappa 0.36,1.0). Discriminant validity between referred and control samples was strong for critical comments, positive comments and warmth, but not significant for emotional overinvolvement or hostility. The same three scales showed strong discriminant validity between child symptom domains, being strongly correlated with conduct symptoms (kappa = 0.49,0.71) but not emotional symptoms (kappa = 0.10,0.17). Sensitivity to change with treatment was shown by a reduction in the mean number of critical comments from 4.7 to 2.9, an increase in positive comments from 2.3 to 3.9, and an increased score on the warmth scale from 2.1 to 2.6. The CFI-C is a useful instrument for the study of the relationship between parenting style and child psychiatric symptoms. Copyright © 2000 Whurr Publishers Ltd. [source]

Affective reactivity in response to criticism in remitted bipolar disorder: a laboratory analog of expressed emotion,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2009
Amy K. Cuellar
Abstract Potential mechanisms to explain the relationship between Expressed Emotion (EE) and poor outcome within bipolar disorder are poorly understood. One possibility is that people with bipolar disorder have difficulty regulating their affect in response to criticism. The present study examined whether participants with bipolar disorder were more affectively dysregulated than control participants when presented with a criticism by a confederate. There was a trend for people with bipolar disorder to react more negatively to the criticism, but there was also evidence that they recovered as quickly as controls. Exploratory analyses found that female gender, the perception of the criticism as more negative, being disabled, and having fewer positive relationships predicted greater reactivity to criticism among people with bipolar disorder. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,17, 2009. [source]

Appraisal of caregiving burden, expressed emotion and psychological distress in families of people with eating disorders: A systematic review

EUROPEAN EATING DISORDERS REVIEW, Issue 5 2009
Maria Jose Zabala
Abstract The purpose of this review is to appraise the literature regarding psychological distress, burden and expressed emotion (EE) in caregivers of people with eating disorders (EDs). Electronic databases were searched up until October 2008. Selected studies contained carers of people with ED and employed one measure of burden, EE or psychological distress. Twenty studies were identified measuring psychological distress burden and EE. Most of the studies examined these features in families of anorexic patients. The majority of the studies found high levels of psychological distress, burden and EE in this population. Only few studies included a control group. Carers of people with ED presented high levels of psychological distress and burden. ED carers tend to have levels of EE resembling that found in families of depressed patients, rather than schizophrenic patients. There is some evidence (particularly for EE) that these factors can impact the outcome of ED. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Collaborative care between professionals and non-professionals in the management of eating disorders: a description of workshops focussed on interpersonal maintaining factors

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2007
J. Treasure
Abstract The aim of this paper is to describe the content and processes involved in a series of workshops for carers of people with an eating disorder. These workshops were designed to equip carers with the skills and knowledge needed to be a ,coach' and help the person with an eating disorder break free from the traps that block recovery. The first hurdle is to overcome the unhelpful patterns of interpersonal processes between the person with an eating disorder and their carers. In both naturalistic studies and randomised controlled trials (RCT), family factors have been implicated either as moderators or mediators of outcome. High levels of expressed emotion (EE), misattributions about the illness or unhelpful methods of engaging with the eating disorder symptoms contribute to this effect. These workshops aim to reduce EE such as over protection. Carers are introduced to the transtheoretical model of change and the principles of motivational interviewing so that they can help rather than hinder change. They learn how to use reflective listening to reduce confrontation and how to sidestep resistance. Carers learn what is needed to help their daughter change by reflecting on the processes involved in changing their own behaviours in relationship with the person with eating disorders. Once they recognise that they may need to change then they can use their skills, information and insight to help change eating disorder symptoms. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Advances in Latino Family Research: Cultural Adaptations of Evidence-Based Interventions

FAMILY PROCESS, Issue 2 2009
GUILLERMO BERNAL PH.D.
The stark contrast between frequent calls for research and practice that are applicable across a broad spectrum of cultural and ethnically diverse groups and the dearth of empirical knowledge about Latino families provided the impetus for this special issue on advances in Latino family research. A focus on empirically based practice frames the issue, focusing specifically on how concepts (expressed emotion, parenting style) can be used within interventions, how Latino parents perceive efforts to deliver evidence-based interventions, and how pilot projects that delivered culturally adapted interventions in three separate cities impacted family functioning. In all, the introduction highlights the complexities for researchers in meeting the needs of the field to ensure that effective interventions are applicable across cultural groups. Meeting the challenges is important to address the need of the growing Latino population. Advances in intervention research with ethnic minorities also stand to contribute to the advancement of intervention research broadly. This special issue provides examples of efforts that are underway to better understand what treatments work for Latino families, provided by whom, for what specific problems, and in which specific circumstances, paving the way to begin attempting to answer a challenge posed more than 40 years ago by Gordon Paul. RESUMEN El marcado contraste entre las frecuentes convocatorias para investigaciones y prácticas aplicables a un amplio espectro de grupos de distintas culturas y razas, y la escasez de conocimiento empírico sobre las familias latinas sirvieron como impulso para publicar este número especial sobre los avances en las investigaciones relativas a las familias latinas. La publicación está enmarcada en el análisis de la práctica sustentada empíricamente, centrándose específicamente en cómo los conceptos (emoción expresada, estilo de crianza de los hijos) pueden utilizarse dentro de las intervenciones, en cómo los padres latinos perciben las iniciativas de realizar intervenciones sustentadas empíricamente y en cómo los proyectos piloto que ofrecieron intervenciones adaptadas culturalmente en tres ciudades distintas influyeron sobre el desenvolvimiento familiar. En general, la introducción destaca las complicaciones que enfrentan los investigadores a la hora de responder a las necesidades del campo para garantizar que puedan aplicarse intervenciones eficaces a distintos grupos culturales. Resolver estas complicaciones es importante para responder a la necesidad de la población latina en aumento. Los avances en las investigaciones sobre intervenciones con minorías étnicas también contribuyen al avance de las investigaciones sobre intervenciones en general. La publicación especial ofrece ejemplos de iniciativas que están en marcha para comprender mejor qué tratamientos son eficaces para las familias latinas, quiénes deben proporcionarlos, para qué problemas específicos y en qué circunstancias específicas, allanando el camino para comenzar a responder un problema que planteó Gordon Paul hace más de 40 años. Palabras clave: Latinos/hispanos, familia, adaptación cultural, intervención, salud mental de los latinos [source]

Cultural Variability in the Manifestation of Expressed Emotion

Expressed Emotion Attitudes and Individual Psychopathology Among the Relatives of Bipolar Patients

FAMILY PROCESS, Issue 4 2002
Tina R. Goldstein M.A.
This study investigated the relationships between expressed emotion (EE) and individual psychopathology among 82 biological and non-biological relatives of 66 patients with bipolar I disorder. Relatives' psychopathology was assessed via the Structured Clinical Interview for DSM-III-R, Patient Version (SCID-P) and the General Behavior Inventory (GBI), a self-report measure of lifetime subsyndromal mood disturbances. We hypothesized that relatives who held high-EE critical, hostile, and/or overinvolved attitudes toward their bipolar family member, as measured via the Camberwell Family Interview, would be more likely to have DSM-III-R Axis I diagnoses on the SCID, as well as more mood and temperamental disturbances on the GBI, than those who held low-EE attitudes. The findings did not support a significant relationship between overall EE status and psychopathology in family members. However, relatives without significant Axis I pathology scored significantly higher than those with Axis I pathology on one measure of EE, emotional overinuolvement. The findings are discussed with reference to explanations for the genesis of high-EE attitudes. [source]

Assessing expressed emotion: comparing Camberwell Family Interview and Five-minute Speech Sample ratings for mothers of children with behaviour problems

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2006
R. Calam
Abstract Little is known of the concordance between ratings of expressed emotion (EE) derived from the Camberwell Family Interview (CFI) and Five-minute Speech Sample (FMSS) for parents of children with behaviour problems. Concordance between CFI and FMSS ratings of EE was assessed prior to intervention and compared to parent-rated behaviour after intervention, at follow-up, 12 months later. Female primary caretakers of 75 children (3,10 years) showing behavioural difficulties were interviewed using FMSS and CFI. Interviews were coded independently by criterion-standard raters. Using CFI, 57 families were classified high EE, and 18 low EE. Using FMSS, 65 families were classified high EE and 10 low EE. 55/75 pairs of ratings (73%) were the same (high, n = 51: low, n = 4) and 20 mothers (27%) were allocated different EE status (Kappa = 0.14, n.s.). The FMSS ratings at initial interview appeared more closely related to behaviour rating at follow-up than CFI. Further investigation is required to establish comparability of CFI and FMSS results for carers of children. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Brief measure of expressed emotion: internal consistency and stability over time

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2003
Seija Sandberg Consultant, Senior Lecturer
Abstract The study examined three methodological aspects of expressed emotion (EE) as assessed in the course of PACE (Psychosocial Assessment of Childhood Experiences) interviews with a parent. In a sample of 87 children, aged 6,13 years, enrolled in a prospective study examining the role of stress on the course of asthma, EE was assessed at three time points, 9 months apart. A high degree of agreement was found among the three concurrent measures of negative and positive EE (kappas from 0.74 to 0.97, and from 0.45 to 0.88, respectively; p , 0.0001 in all instances). The temporal stability of all measures was lower, although statistically significant in all but 2 instances (kappas from 0.19 to 0.59, and from 0.11 to 0.39, respectively). The temporal stability across measures, as well as across interviewers and over time, was broadly similar (kappas from 0.21 to 0.56 for negative EE, and from 0.09 to 0.38 for positive EE, with all but three of the 36 statistically significant). The findings provide support for the underlying assumptions of the PACE-EE and show the utility of measures based on just very brief periods of non-directive interviewing, making them practical in a wide range of studies with EE just one of a larger set of measures. Copyright © 2003 Whurr Publishers Ltd. [source]

Relational problems and psychiatric symptoms in couple therapy

INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 4 2005
Ann-Marie Lundblad
This article describes couples attending family counselling in Sweden. The study group is compared with clinical groups and non-clinical groups. Self-rating instruments were com-pleted by 317 women and 312 men to evaluate the following: marital satisfaction (DAS), expressed emotion (QAFM), family climate (FC), psychiatric symptoms (SCL-90) and sense of coherence (SOC). This group had several problems: marital relationships, disrupted family functioning, dyadic interactions characterised by criticism and open arguments, and multiple psychological symptoms. The women were espe-cially discontent in the relationship, and they exhibited higher symptom strain and lower sense of coherence than the men did. Compared with non-clinical populations, this group was severely distressed and was similar to in-patient families in child psychiatric clinics. The low sense of coherence of the individuals in the group under study means that their sense of having a meaningful life and their ability to comprehend and manage problems were severely compromised. Adequate and comprehensive treatment within the framework of social pro-grammes should be made available to these couples and others in a similar situation. [source]

Affective reactivity in response to criticism in remitted bipolar disorder: a laboratory analog of expressed emotion,

Family-focused treatment for bipolar disorder in adults and youth

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2007
Chad D. Morris
Levels of familial expressed emotion during an acute episode are consistently associated with rates of recurrence among bipolar patients. This article briefly reviews the evidence for expressed emotion (EE) as a prognostic indicator and then illustrates family-focused treatment (FFT) with adults and adolescents suffering from bipolar disorder. FFT is a time-limited, modularized treatment consisting of psychoeducation, communication enhancement training, and problem-solving skills. Controlled trials indicate that FFT is an efficacious adjunct to pharmacotherapy for patients with bipolar disorder. We describe its recent application to early onset bipolar patients and include a clinical vignette. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 433,445, 2007. [source]

Mothers' expressed emotion towards children with and without intellectual disabilities

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2004
A. Beck
Objectives To identify factors associated with maternal expressed emotion (EE) towards their child with intellectual disability (ID). Design and method A total of 33 mothers who had a child with ID and at least one child without disabilities between the ages of 4 and 14 years participated in the study. Mothers completed self-assessment questionnaires which addressed their sense of parenting competence, beliefs about child-rearing practices, and their reports of behavioural and emotional problems of their child with ID. Telephone interviews were conducted to assess maternal EE towards the child with ID and towards a sibling using the Five Minute Speech Sample (FMSS; Magana et al. 1986), and also to assess the adaptive behaviour of the child with ID using the Vineland Adaptive Behaviour Scale (VABS; Sparrow et al. 1984). Results Mothers with high EE towards their child with ID were more satisfied with their parenting ability, and their children had more behaviour problems. Analysis of differential maternal parenting, through comparisons of EE towards their two children, showed that mothers were more negative towards their child with ID for all domains of the FMSS except dissatisfaction. Conclusions A small number of factors associated with maternal EE towards children with ID were identified. Differences in maternal EE towards their child with ID and their other child suggest that EE is child-driven rather than a general maternal characteristic. Implications of the data for future research are discussed. [source]

Clinical governance in practice: closing the loop with integrated audit systems

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2006
L. TAYLOR ba hons rmn
Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision-making processes and care delivery as a result of the audit. Brief clinical examples are given. In conclusion, the impact of the audit on unit strategy and organizational efficiency are discussed to highlight the importance of closing the audit loop and completing the cycle of clinical governance. The audit system has positive implications for replication in other services. [source]

The perceived expressed emotion in staff scale

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2003
J. FORSTER
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. [source]

Direct effects of short-term psychoeducational intervention for relatives of patients with schizophrenia in Japan

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006
HAJIME YAMAGUCHI md
Abstract, This study examined the direct effects of short-term psychoeducation on relatives of inpatients with schizophrenia, with the goal of introducing this type of support program into standard care. The subjects were 46 relatives of inpatients with schizophrenia who attended three or four sessions of psychoeducation. Levels of anxiety and subjective burden and distress were measured before and after sessions using self-administered rating scales. In addition, levels of expressed emotion were also measured. Results showed that both state and trait anxiety on the State-Trait Anxiety Inventory were significantly lower after psychoeducational intervention than before intervention. In addition, subjective burden and distress reported by the family significantly decreased on the subscales for family confusion resulting from a lack of knowledge of the illness and anxiety about the future, subjective burden and depression resulting from the patient's illness, and difficulties in the relatives' relationships with the patient. Comparison of high and low expressed emotion families showed that the intervention was almost equally effective for the two groups. However, its effectiveness with regard to the subjective burden and depression experienced by the families was significantly greater among high expressed emotion families. The present study confirmed that family psychoeducation during hospitalization, even for a short period, is effective for all families, whether high or low expressed emotion. Moreover, the results suggested that the intervention may have a greater effect on emotional factors in high expressed emotion families than in low expressed emotion families. [source]

Do great apes use emotional expressions to infer desires?

DEVELOPMENTAL SCIENCE, Issue 5 2009
David Buttelmann
Although apes understand others' goals and perceptions, little is known about their understanding of others' emotional expressions. We conducted three studies following the general paradigm of Repacholi and colleagues (1997, 1998). In Study 1, a human reacted emotionally to the hidden contents of two boxes, after which the ape was allowed to choose one of the boxes. Apes distinguished between two of the expressed emotions (happiness and disgust) by choosing appropriately. In Studies 2 and 3, a human reacted either positively or negatively to the hidden contents of two containers; then the ape saw him eating something. When given a choice, apes correctly chose the container to which the human had reacted negatively, based on the inference that the human had just eaten the food to which he had reacted positively , and so the other container still had food left in it. These findings suggest that great apes understand both the directedness and the valence of some human emotional expressions, and can use this understanding to infer desires. [source]

Encoding of Facial Expressions of Emotion and Knowledge of American Sign Language

JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 1 2000
NAOMI E. GOLDSTEIN
The relationship between knowledge of American Sign Language (ASL) and the ability to encode facial expressions of emotion was explored. Participants were 55 college students, half of whom were intermediate-level students of ASL and half of whom had no experience with a signed language. In front of a video camera, participants posed the affective facial expressions of happiness, sadness, fear, surprise, anger, and disgust. These facial expressions were randomized onto stimulus tapes that were then shown to 60 untrained judges who tried to identify the expressed emotions. Results indicated that hearing subjects knowledgeable in ASL were generally more adept than were hearing nonsigners at conveying emotions through facial expression. Results have implications for better understanding the nature of nonverbal communication in hearing and deaf individuals. [source]