Carers' attributions about positive events in psychosis relate to expressed emotion

Background

Relapse is increased in people with psychosis who live with carers with high expressed emotion (EE). Attributional style has been used to understand EE at a psychological level. Previous studies have investigated carer appraisals for negative events in the patient's life. We therefore aimed to examine spontaneous carer attributions for both negative and positive events. Further, we distinguished between high EE based on critical comments, and that based on emotional-overinvolvement.

Method

Audiotapes of the Camberwell Family Interview (CFI) (N = 70) were rated using the Leeds Attributional Coding System (LACS). Raters were blind to previous ratings of EE.

Results

In our sample, low EE carers made significantly more attributions about positive events, and less about negative events than high EE carers. This is because criticism, but not overinvolvement, was strongly associated with responsibility attributions for negative events, while overinvolvement, but not criticism, was inversely associated with responsibility attributions for positive events.

Conclusion

Carers' attributions for both positive and negative events may be a useful target for improving family interventions in psychosis.     

Influence of expressed emotion and perceived criticism on cognitive-behavioral therapy for social phobia

This study examined significant others' expressed emotion (EE) and a closely related construct, perceived criticism, as predictors of cognitive-behavioral therapy outcome in a sample of 40 patients with social phobia (social anxiety disorder). Patients enrolled in group therapy for social phobia completed pre- and post-treatment questionnaire measures of perceived criticism and anxious and depressive symptoms. Designated significant others were assessed for the components of high EE (criticism, hostility and emotional overinvolvement) using the Camberwell Family Interview. It was hypothesized that these high-EE components and patients' perceived criticism would be associated with poorer treatment outcome, and results ran counter to these expectations. Controlling for initial social phobia severity, lower levels of perceived criticism predicted treatment dropout. There was also a nonsignificant trend for participants with a significant other rated as high in emotional overinvolvement to show less change on a composite symptom measure. Findings from this study suggest that close relationships impact the outcome of cognitive-behavioral interventions for social phobia.     

Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients

This study investigates the relationship between expressed emotion (EE) and causal attributions in relatives of post-traumatic stress disorder (PTSD) patients, and examines the contributions of EE and attributions to patient outcomes. Thirty-eight relatives of patients with PTSD participating in a treatment trial were assessed on EE, causal attributions for patient problems and nature of attributions. Patients' PTSD symptoms at 6 and 12 months were assessed. Criticism and hostility in relatives were associated with attributing problems to factors controllable by patients. Relatives with marked emotional over-involvement (EOI) had an attributional profile similar to low EE relatives. Deficits in normal behaviour ("negative symptoms") were perceived as more controllable, internal and stable than were more obvious signs of an illness or mental health problem such as hypervigilance and intrusive thoughts and nightmares ("positive symptoms"). Irritability or anger was perceived as more controllable and personal than any other problem. Hostility was associated with less psychological understanding. EE (hostility) but not attributions was found to predict clinical outcome. The results are consistent with previous studies of relatives of schizophrenia patients. The study suggests a need for interventions, which focus on helping relatives to reappraise the impact of PTSD.     

Family expressed emotion prior to onset of psychosis

This study compared components of expressed emotion (EE; rejection, warmth, protectiveness, and fusion) across three samples: two in which the subjects had an established schizophrenic or mood disorder, and a third in which the subjects were at high risk for an initial psychosis. METHODS: Family members rated themselves on the Social Adjustment Scale-III and, in the prodromal sample, estimated the duration of the prodrome. RESULTS: Scores were all but identical in the two established-disorder samples but were markedly higher than scores in the prodromal sample on all four factors. In mothers, warmth (decreasing), rejection, protectiveness, and fusion (increasing) were significantly correlated with duration of prodrome, whereas for fathers, warmth and protectiveness were similarly correlated. CONCLUSION: These data suggest that expressed emotion is largely reactive to deterioration manifested by the young person developing a psychotic disorder, rather than a trait of family members.     

Links between early baseline cortisol,attachment classification,and problem behaviors: A test of differential susceptibility versus diathesis-stress

The purpose of the current study was to predict concurrent levels of problem behaviors from young children’s baseline cortisol and attachment classification, a proxy for the quality of caregiving experienced. In a sample of 58 children living at or below the federal poverty threshold, children’s baseline cortisol levels, attachment classification, and problem behaviors were assessed at 17 months of age. We hypothesized that an interaction between baseline cortisol and attachment classification would predict problem behaviors above and beyond any main effects of baseline cortisol and attachment. However, based on limited prior research, we did not predict whether or not this interaction would be more consistent with diathesis-stress or differential susceptibility models. Consistent with diathesis-stress theory, the results indicated no significant differences in problem behavior levels among children with high baseline cortisol. In contrast, children with low baseline cortisol had the highest level of problem behaviors in the context of a disorganized attachment relationship. However, in the context of a secure attachment relationship, children with low baseline cortisol looked no different, with respect to problem behavior levels, then children with high cortisol levels. These findings have substantive implications for the socioemotional development of children reared in poverty.     

Acceptance and expressed emotion in Mexican American caregivers of relatives with schizophrenia

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.     

Changes in maternal expressed emotion toward clinically anxious children following cognitive behavioral therapy

The aim of this study was to determine whether maternal expressed emotion (criticism and emotional overinvolvement) decreased across treatment for childhood anxiety. Mothers of 48 clinically anxious children (aged 6-14 years) were rated on levels of criticism (CRIT) and emotional overinvolvement (EOI), as measured by a Five Minute Speech Sample (FMSS) from mothers, prior to and following cognitive behavioral therapy (CBT) for their children’s anxiety. Results showed a significant decrease in the proportion of mothers who expressed high levels of criticism and emotional overinvolvement from pretreatment to posttreatment. This finding suggests that interventions aimed at reducing symptoms of child anxiety can also result in a decrease of maternal expressed emotion (criticism and emotional overinvolvement).     

Behavioural inhibition, anxious symptoms, and depressive symptoms: a short-term prospective examination of a diathesis-stress model

The purpose of the current study was to examine the relationship between behavioural inhibition (BI) and anxious symptoms within a diathesis-stress framework, using a short-term prospective design. In addition, we examined whether BI acts as a specific vulnerability to anxious symptoms, or as a common vulnerability to both anxious and depressive symptoms. At time 1, 384 children in grades 3 through 6 completed self-report measures of BI, anxious symptoms, and depressive symptoms. Six weeks later, they completed self-report measures of hassles, anxious symptoms, and depressive symptoms. Results demonstrated that children with high BI who experienced high levels of hassles during the 6-week follow-up interval showed increases in anxious symptoms, but not depressive symptoms.     

Nonreligious coping and religious coping as predictors of expressed emotion in relatives of patients with schizophrenia

Expressed emotion (EE) is a measure of the amount of criticism and emotional over involvement expressed by a key relative towards a relative with a disorder or illness. Research has established that living in a high EE environment, which is characterised by increased levels of critical and emotionally exaggerated communication, leads to a poorer prognosis for patients with a mental illness when compared to low EE environments. Despite evidence that EE is a strong predictor of the course of the illness, there continue to be questions concerning why some family members express excessive levels of high EE attitudes about their mentally ill relatives while others do not. Based on indirect evidence from previous research, the current study tested whether religious and nonreligious coping serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed an EE interview, along with questionnaires assessing situational nonreligious coping and religious coping. In line with the hypotheses, results indicated that nonreligious coping predicted EE. Specifically, less use of adaptive emotion-focused coping predicted high EE. Also consistent with predictions, maladaptive religious coping predicted high EE above and beyond nonreligious coping.     

Family expressiveness and parental emotion coaching: their role in children's emotion regulation and aggression

In this study, we explored the relations between positive and negative family expressiveness, parental emotion coaching, child emotion regulation, and child aggression. The sample included 120 fourth-grade children and their mothers. Mothers completed the Emotion Regulation Checklist, the Family Expressiveness Questionnaire, and a portion of the meta-emotion interview to assess their awareness and acceptance of, and instruction in managing their child's anger and sadness (3 dimensions of parental emotion coaching). Teachers rated each child's aggression and completed the Emotion Regulation Checklist for each child. The 3 dimensions of parental emotion coaching and positive and negative family expressiveness were not directly related to child aggression. However, both negative family expressiveness and the mother's acceptance of the child's negative emotions were indirectly related to child aggression through the child's emotion regulation.     

A dynamical systems interpretation of a dimensional model of emotion

The dimensional structure of emotion was investigated using self reports of induced mood and idiographic and nomothetic analyses. Subjects attended four experimental sessions during which an array of affective states was induced via auditory, visual, and imaginal channels. For each of 118 stimulus events, subjects self-rated their response. Factor analysis yielded the predicted bipolar factors of valence and arousal: these were obtained in group-aggregated analysis and subsequently confirmed as change dimensions at the intraindividual level. Controversy over the fundamental dimensions of affective space was considered with respect to methodological issues such as factor rotation and sampling of data space. Valence and arousal are discussed as motivational, driving parameters of affective experience and a dynamical systems conceptualization of emotion is proposed.     

The time course of positive and negative emotion in dysphoria

Prior research has demonstrated attenuated reactivity to positive stimuli among depressed and dysphoric individuals, and inconsistent evidence regarding attenuated reactivity to negative stimuli. However, such research has measured experiential reactivity to emotion stimuli in one static moment, which may obscure important information regarding the time course and dynamics of emotion. The current study employed continuous measurement of experiential emotion during and following the presentation of emotion eliciting film clips. Results revealed that dysphoric individuals (n = 16), as compared to nondysphoric controls (n = 31), were equally responsive to positive and negative film clips in terms of peak reactivity during and following the clip. The most striking difference between groups was that dysphoric individuals showed a shortened time course of positive emotion. These emotion dynamics suggest that perhaps the most important aspect of positive emotion regulation in the context of depressed mood is not the inability to initially react to a positive experience, but rather the inability to maintain positive emotion. Possible underlying mechanisms of positive emotion regulation are discussed, and implications for intervention are highlighted.     

伪装情绪的人际影响及其作用机制

伪装情绪是指在情绪交互的过程中, 人们展现实际不存在的积极或消极情绪, 放大亦或是压抑原本的情绪。伪装情绪是一种策略选择的结果, 表现者所展现的情绪在当下可能并未发生, 但却能在某种程度上令人信服。目前关于伪装情绪的研究比较分散, 对于伪装情绪人际影响及其作用机制还存在着一定争议。现有文献多从博弈过程、亲社会行为情境、组织情境和领导效果四个方面对伪装情绪的人际效应进行探讨, 其中相关的机制包括情绪接受者的情感反应及“以己度人”的内心过程。未来的研究可以从情绪接受者、群体伪装、伪装情绪效价、认知神经机制以及文化等方面, 对伪装情绪展开深入系统性的研究。     

The effect of emotional clarity and attention to emotion on job satisfaction: A mediating role of emotion regulation among Chinese medical staff

The present study examined the relationships among attention to emotion, emotional clarity, emotion regulation, and job satisfaction, and tested whether the plausible associations between emotional processes (e.g., attention to emotion, emotional clarity) and job satisfaction can be mediated by emotion regulation in a sample of Chinese medical staff. In total, 1,766 medical staff in Guangdong province completed questionnaires including the demographics, the Minnesota Satisfaction Questionnaire, Emotional Clarity, Attention to Emotion, and the Emotion Regulation Questionnaire. Results showed significant direct effect of emotional clarity, but not attention to emotion on job satisfaction. Cognitive reappraisal significantly mediated the associations between emotional processes (e.g., attention to emotion, emotional clarity) and job satisfaction whereas expressive suppression was not a statistically significant mediator. These results suggest that attention to emotion and emotional clarity contribute to job satisfaction by increasing certain emotion regulation strategies such as reappraisal. Intervention or medical education programs targeting enhancing emotional clarity and reappraisal may be beneficial for increasing job satisfaction of medical staff in China.     

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

Background and objectives: Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

Methods: A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N?=?62; HSA) and low (N?=?52; LSA) on social anxiety.

Results: Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

Conclusions: Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.     

A minimal ingroup advantage in emotion identification confidence

Emotion expressions convey valuable information about others’ internal states and likely behaviours. Accurately identifying expressions is critical for social interactions, but so is perceiver confidence when decoding expressions. Even if a perceiver correctly labels an expression, uncertainty may impair appropriate behavioural responses and create uncomfortable interactions. Past research has found that perceivers report greater confidence when identifying emotions displayed by cultural ingroup members, an effect attributed to greater perceptual skill and familiarity with own-culture than other-culture faces. However, the current research presents novel evidence for an ingroup advantage in emotion decoding confidence across arbitrary group boundaries that hold culture constant. In two experiments using different stimulus sets participants not only labeled minimal ingroup expressions more accurately, but did so with greater confidence. These results offer novel evidence that ingroup advantages in emotion decoding confidence stem partly from social-cognitive processes.     

A trimodal behavioral conceptualization of clinical pain.

A trimodal behavioral conceptualization of pain is outlined in the current article. It proposes that pain should be viewed as an interacting cluster of gross motor, cognitive, and physiological responses. Such a conceptual system is thought to contain the basic properties needed to incorporate current divergent views of pain held by medical and behavior science into a common conceptual framework.     

A discrete emotions approach to positive emotion disturbance in depression

Converging findings suggest that depressed individuals exhibit disturbances in positive emotion. No study, however, has ascertained which specific positive emotions are implicated in depression. We report two studies that compare how depressive symptoms relate to distinct positive emotions at both trait and state levels of assessment. In Study 1 (N=185), we examined associations between depressive symptoms and three trait positive emotions (pride, happy, amusement). Study 2 compared experiential and autonomic reactivity to pride, happy, and amusement film stimuli between depressive (n=24; DS) and non-depressive (n=31; NDS) symptom groups. Results indicate that symptoms of depression were most strongly associated with decreased trait pride and decreased positive emotion experience to pride-eliciting films. Discussion focuses on the implications these findings have for understanding emotion deficits in depression as well as for the general study of positive emotion.