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At least 19 recordsLinked to original sources
PubMed1992

A Portuguese/Brazilian study of Expressed Emotion.

Expressed Emotion is a measure of family interaction, widely used in studies around the world to predict relapse in severe psychiatric disorders. The instrument was originally developed in London. It depends on subtle vocal nuances emerging in the course of the Camberwell Family Interview (CFI). The extent to which these can be picked up in different languages and different cultures is an interesting question. This paper presents the results of a study of EE from Brazil. The two raters achieved good reliability with master tapes in English, and the CFI was then translated into Portuguese. The raters also showed good reliability in Portuguese. This is at least consistent with the idea that similar behaviours can be picked up in different languages and cultures. Twenty nine relatives of 24 patients with schizophrenia were interviewed using the CFI. It was predicted that high Expressed Emotion would be rare in Brazil, a developing country. In fact, 59% of relatives were rated as high EE. Unlike studies from fully industrialized nations this high level of high EE was largely due to over-involvement. Our findings suggest both contextual and cultural influences on the relative salience of the different components of EE, a theme worth pursuing.

Adult↗
PubMed1989

Lithium prophylaxis and expressed emotion.

Expressed emotion (EE) in key relatives of 21 patients with bipolar affective or schizoaffective psychoses was assessed by the CFI. All patients had been on prophylactic lithium for at least three years and were without psychotic symptoms at interview. The relationship between relatives' EE status and patients' course of illness was studied both retrospectively and prospectively. Two critical remarks designated high EE. The relatives' EE status was not related to number of hospital admissions or to severity and length of recurrences if the entire period of lithium treatment is considered as a whole. However, patients living with high-EE relatives showed a significantly poorer response during the three years before interview, and an even poorer response in the nine-month follow-up.

Adult↗
PubMed2000

Personality and expressed emotion.

Expressed emotion (EE) is an established psychosocial predictor of relapse in patients with schizophrenia and mood disorders; however, nothing is currently known about the personality characteristics of high- and low-EE relatives. A total of 45 relatives of schizophrenia patients completed the California Psychological Inventory, a widely used measure of common personality traits. Compared with low-EE relatives, high-EE relatives were more conventional in their behavior (higher norm-favoring) and less satisfied with themselves and their lives (lower self-realization). High-EE relatives were also less flexible, tolerant, and lower in empathy and achievement via independence than were low-EE relatives. Even with statistical control of potential demographic confounds, flexibility remained a significant predictor of EE status.

Adult↗
PubMed2001

The specificity of infant emotional expression for emotion perception.

Attachment theory emphasizes the role of negative emotional expression in infancy for establishing proximity to and care of the caregiver. According to Lang's biphasic model of emotions protective reflexes (e.g. startle response) are primed if a defensive motivational set is activated. The aim of the study was to examine whether the perception of an infant emotional expression can prime such defensive behavior. The sample consisted of 48 university students. Startle reflex, corrugator and zygomatic EMG activity and subjective ratings of valence and arousal were assessed as a response to presentation of pictures of different emotional valence. Affective startle modulation was obtained when probes were presented during pictures of the International Affective Pictures System replicating previous findings. By contrast, negative infant emotion pictures did not prompt an augmentation of the startle response, although both the subjective ratings and the mimic EMG activity indicated a clear differentiation between negative and positive infant pictures. This pattern of findings was found only in a between-subject design, but not when the two picture sets were presented in the same session, indicating an interference of contrasting content of pictures.

Adult↗
PubMedDate not supplied

[Update on "expressed emotions"].

The present article is meant to sum up the current state of scientific knowledge with regard to the concept of "Emotional Expression" and its very implementation in the clinical and therapeutical field which are well-known in anglo-saxon countries but very little applied and known in France. "Emotional Expression" (EE), which came out of research and studies undertaken by Brown (1959) and later on, Vaughn and Leff (1976), defines interaction between a schizophrenic patient and his close environment according to 3 criterium: judgmental comments and criticism, hostility, emotional over-involvement. Family surroundings are characterized by strong EE or weak EE according to the frequency and the quantity of the measures during a typical standard family-interview: the Camberwell Family Interview (CFI). A strong EE is considered as being a non-specific factor. "Emotional Expression" proves to be a predictable indication for relapse in terms of psychiatric affluence (positive symptoms), hospitalization rate and psycho-social adjustment process. The possibilities of forecasting do not concern specifically schizophrenia as the relation between family climate and relapse can be observed in other mental pathology as well. The psycho-educational approach which is induced by this research trend is based on a concept of a partnership between the patients's family and the patient. The purpose in fact is to bring about changes within the relationship of the patient and his environment so as to reduce judgmental criticism, hostility and emotional over-involvement (information programs concerning etiology, therapeutical strategies in view of improving understanding of the illness and to reorganize proper family relationship). The advantage of such a concept which is well-known lies in the fact that it helps to find out those family surroundings with strong EE who represent factors of relapse for psychiatric patients and to suggest therefore therapeutical treatment, the purpose of which should be defined together with all those concerned namely, the patient, the family, the therapeutist so as to intervene during the evolution of the illness. The literary bibliographical review which we have made lead us to find the existence of a wide field of research with results showing clearly the predictable aspects of EE in the illness process. In this way, new approaches in the "intake" of schizophrenic patients and their families are clearly defined.

Expressed Emotion↗
PubMed1998

Ambivalence over emotional expression and reading emotions in situations and faces.

Three studies explored the relation of ambivalence over emotional expression (AE) and emotional expressiveness (EE) to reading the emotions of others. In Study 1 (N = 340, 110 men), AE positively correlated and EE negatively correlated with self-reported confusion in reading others' emotions. In Studies 2 and 3, participants wrote descriptions of the emotions likely to be felt by a person in an emotional scenario or in a slide of a universal facial expression. Descriptions were content analyzed for emotion words. Results revealed significant AE x EE interactions. In both studies, inexpressive ambivalent individuals used emotion words of the opposite valence of that implied in the scenes or expressions. Implications for social relationships are discussed.

Adolescent↗
PubMed1988

The Level of Expressed Emotion Scale: a new measure of expressed emotion.

The Level of Expressed Emotion (LEE) scale was developed to provide an index of the perceived emotional climate in a person's influential relationships. Unlike existing measures, the scale was constructed on the basis of a conceptual framework described by expressed emotion theorists. In addition to providing an overall score, the 60-item scale assesses the following four characteristic attitudes or response styles of significant others: Intrusiveness, emotional response, attitude toward illness, and tolerance/expectations. The scale underwent extensive psychometric development procedures: (1) theoretically based item generation; (2) pilot testing with normal and psychiatric populations to select the final items; and (3) construct validation within a schizophrenic population. The results were quite favorable and indicate that the LEE scale has sound psychometric properties of internal consistency; reliability; independence from sex, age, and amount of contacts; and construct validity.

Adaptation, Psychological↗
PubMed1976

The measurement of expressed emotion in the families of psychiatric patients.

In a series of studies of the influence of family life on the course of an established schizophrenic illness, it has been shown that the level of emotion expressed by relatives shortly after a schizophrenic patient is admitted to hospital is strongly associated with symptomatic relapse during the nine months following discharge (Brown et al., 1962, 1972). This paper states the case for an abbreviated version of the primary research instrument used in these studies, the Camberwell Family Interview Schedule. In the 1972 study the single most important measure contributing to the overall expressed emotion index proved to be the number of critical remarks made about the patient by the relative when interviewed alone. An analysis of 15 tape-recorded interviews from this study showed that the majority of critical comments were produced within the first hour and there was virtually no relationship between total number of critical comments and length of interview (r = 0.08). This analysis supported the use of a shortened interview in which the areas most likely to produce any criticism were given priority in the sequence of questioning. This abbreviated version has been used successfully in a replication and extension of the 1972 study. A group of 37 schizophrenic patients is being compared with a group of 31 depressed neurotic patients. Patterns of emotional response of these patients' relatives are discussed.

Child↗
PubMed1992

Factor analysis of the level of expressed emotion scale, a questionnaire intended to measure 'perceived expressed emotion'.

When the factor structure and psychometric qualities of the Level of Expressed Emotion scale, an instrument intended to assess patient's perceptions of expressed emotion, were evaluated, three moderately intercorrelated factors emerged, with good internal consistency; these were lack of emotional support, intrusiveness/control, and irritability. This did not quite correspond to the a priori scales described in the original version. As in the original LEE, the three factors add to a total score intended to measure 'perceived expressed emotion'.

Adolescent↗
PubMed1999

Emotional expression and feeling in schizophrenia: effects of specific expressive behaviors on emotional experiences.

The purpose of this study was to investigate the relationship between emotional expression and experience in schizophrenia by manipulating expressive behaviors directly and then assessing subsequent emotional feelings. In Study 1, facial expressions and bodily postures were manipulated in a sample of normals, the results of which replicate findings from previous studies of peripheral feedback effects on emotions. In Study 2, the same procedures were used with matched groups of outpatient schizophrenic men, patients with depression, and nonpsychiatric controls. Schizophrenia patients showed the usual effects from their facial expressions of sadness, fear, happiness, and surprise, but only from their postures of anger, whereas patients with depression showed the same effects only from their expressions and postures of sadness, and normal controls only from their expressions and postures of anger. These patterns may reflect those aspects of the emotional response system that are functional and dysfunctional in schizophrenia and depression.

Adolescent↗
PubMed2000

The expressed emotion of case managers of the seriously mentally ill: the influence of expressed emotion on clinical outcomes.

BACKGROUND: Expressed emotion (EE) measured from relatives and informal carers has been consistently demonstrated to be associated with clinical outcome in schizophrenic patients. There have also been published studies that have investigated EE in professional carers that have suggested that the quality of the relationship between staff and patient may also be associated with patient outcomes. A large controlled trial of the effectiveness of different intensities of case management provided the opportunity to assess the association between the EE of case managers, including the quality of the relationship they had with patients under their care, and later clinical outcomes. METHOD: This was a prospective naturalistic study of EE present in a case manager patient dyad and subsequent patient outcomes. EE was assessed from the Five Minute Speech Sample (FMSS) at least 3 months after the case manager became responsible for the patient's care and a range of clinical outcomes were assessed 6 to 9 months later. Assessment of clinical outcomes was made independent and blind of the EE ratings. RESULTS: High EE ratings were significantly associated with individual case managers and not to symptom or illness factors. High EE was not associated with later clinical outcome, however, the positive relationship between case manager and patient was. The absence of a positive relationship was significantly associated with poorer outcomes. CONCLUSIONS: In spite of very low face-to-face contact between case managers and patients, compared with the amount of contact patients have with their informal carers and family, aspects of staff attitudes and behaviour did influence clinical outcome. There are potential implications of these results for staff training and clinical practice.

Adult↗
PubMed1987

Expressed emotion and schizophrenia in north India. II. Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh.

We measured the components of expressed emotion among two samples of relatives of first-contact patients from Aarhus (Denmark) and Chandigarh (India). The Danes were very similar in most respects to samples of British relatives, whereas the Indian relatives expressed significantly fewer critical comments, fewer positive remarks, and less over-involvement. Within the Chandigarh sample, city-dwellers were significantly more expressive than villagers of all EE components except over-involvement.

Adolescent↗
PubMed1990

Perceived intimacy of expressed emotion.

Research on norms for emotional expression and self-disclosure provided the basis for two hypotheses concerning the perceived intimacy of emotional self-disclosure. The first hypothesis was that the perceived intimacy of negative emotional disclosure would be greater than that of positive emotional disclosure; the second was that disclosures of more intense emotional states would be perceived as more intimate than disclosures of less intense emotional states for both negative and positive disclosures. Both hypotheses received support when male students in Canada rated the perceived intimacy of self-disclosures that were equated for topic and that covered a comprehensive sample of emotions and a range of emotional intensities. The effects were observed across all the topics of disclosure examined.

Adolescent↗
PubMedDate not supplied

[Emotional expression: from research to psychosocial treatment].

Over a four year period, the Schizophrenia Research Association (A.R.S. - Associazione Ricerche sulla Schizofrenia) has drawn up a multi-dimensional plan of action for the families of schizophrenic subjects. The basic points of this plan revolve around advice to the family and group therapy for family members, split into "informative" and "relationship orientation" sessions. Conducting an assessment of Expressed Emotion on family members admitted to these groups, it was observed that their emotional make-up is very different from that of family members of schizophrenics selected on the basis of casual criteria. Therefore, we are proposing a strategy which takes into account the emotional make-up of the family member in dictating therapists' action in terms of each family member.

Emotions↗
PubMed1995

[Stability and predictive role of emotions, expressed by families in the development of a cohort of schizophrenic patients in the course of 5 years].

A prospective study of 44 first admission schizophrenic patients was conducted in Geneva, in order to evaluate the prognostic value of Expressed Emotion (EE), as well as its stability. The predictive power of the EE index was tested on three variables of outcome: relapse rate, social adaptation and hospital stay. At intake, the patients presenting more premorbid features lived in high EE households. The EE index and the outcome measures tended to be associated. After the third year, patients living with high EE relatives were significantly more maladjusted and relapsed more than those living with low EE relatives. The EE index was stable during the five years. Our results show that initial measure of EE in a first episode cohort is predictive of outcome over a five year period. This may not be causal as it cannot be excluded that poorer premorbid functioning alone may result in poorer outcome, and may also elicit high EE in relative.

Adult↗
PubMed1987

Expressed emotion and schizophrenia in north India. III. Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh.

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo-American studies for 'high EE', we found a significant relationship between high EE and relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.

Attitude to Health↗
PubMed1992

The measurement of expressed emotion: a review.

Expressed emotion refers to the affective attitudes and behaviours (i.e., criticism, hostility and emotional overinvolvement) of relatives toward a family member with a psychiatric illness. In this article, the Camberwell Family Interview, the standard method used to assess expressed emotion, and alternative approaches to the measurement of expressed emotion are reviewed. While there is a reasonable correspondence between ratings derived from the Camberwell interview and the less arduous alternative methods, the association is not perfect. In addition, the conceptual similarities and prognostic utility of these measures require replication and further exploration. Of the alternative assessment methods available, the use of the Five Minute Speech Sample or the Level of Expressed Emotion Scale as screening devices is recommended.

Attitude to Health↗