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1.
PLoS One ; 19(3): e0300518, 2024.
Article in English | MEDLINE | ID: mdl-38512817

ABSTRACT

Research into clinical applications of speech-based emotion recognition (SER) technologies has been steadily increasing over the past few years. One such potential application is the automatic recognition of expressed emotion (EE) components within family environments. The identification of EE is highly important as they have been linked with a range of adverse life events. Manual coding of these events requires time-consuming specialist training, amplifying the need for automated approaches. Herein we describe an automated machine learning approach for determining the degree of warmth, a key component of EE, from acoustic and text natural language features. Our dataset of 52 recorded interviews is taken from recordings, collected over 20 years ago, from a nationally representative birth cohort of British twin children, and was manually coded for EE by two researchers (inter-rater reliability 0.84-0.90). We demonstrate that the degree of warmth can be predicted with an F1-score of 64.7% despite working with audio recordings of highly variable quality. Our highly promising results suggest that machine learning may be able to assist in the coding of EE in the near future.


Subject(s)
Expressed Emotion , Speech , Child , Humans , Emotions , Language , Reproducibility of Results , Twin Studies as Topic
2.
Int J Eat Disord ; 57(3): 682-694, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38318997

ABSTRACT

OBJECTIVE: To examine the feasibility and acceptability of augmenting family-based treatment (FBT) for adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) with a parent emotion coaching intervention (EC) focused on reducing parent expressed emotion. METHOD: In this pilot effectiveness trial, families of adolescents with AN/AAN exhibiting high expressed emotion received standard FBT with either (1) EC group or (2) support group (an attention control condition focused on psychoeducation). RESULTS: Forty-one adolescents with AN or AAN were recruited (88% female, Mage = 14.9 ± 1.6 years, 95% White: Non-Hispanic, 1% White: Hispanic, 1% Bi-racial: Asian). Most study adolescents were diagnosed with AN (59%) while 41% were diagnosed with AAN. Participating parents were predominantly mothers (95%). Recruitment and retention rates were moderately high (76% and 71%, respectively). High acceptability and feasibility ratings were obtained from parents and interventionists with 100% reporting the EC intervention was "beneficial"-"very beneficial." The FBT + EC group demonstrated higher parental warmth scores at post-treatment compared to the control group (standardized effect size difference, d = 1.58), which was maintained at 3-month follow-up. Finally, at post-treatment, the FBT + EC group demonstrated higher rates of full remission from AN/AAN (40%) compared to FBT + support (27%), and were nine times more likely to be weight restored by 3-month follow-up. DISCUSSION: Augmenting FBT with emotion coaching for parents with high expressed emotion is acceptable, feasible, and demonstrates preliminary effectiveness. PUBLIC SIGNIFICANCE: Family based treatment for AN/AAN is the recommended treatment for youth but families with high criticism/low warmth are less likely to respond to this treatment. Adding a parent emotion coaching group (EC) where parents learn to talk to their adolescents about tough emotions is feasible and well-liked by families.


Subject(s)
Anorexia Nervosa , Mentoring , Humans , Adolescent , Female , Male , Expressed Emotion , Anorexia Nervosa/therapy , Anorexia Nervosa/psychology , Treatment Outcome , Family Therapy , Emotions
3.
Psychotherapy (Chic) ; 61(1): 82-92, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38236227

ABSTRACT

The association between emotional experience and expression, known as emotional coherence, is considered important for individual functioning. Recent advances in natural language processing (NLP) make it possible to automatically recognize verbally expressed emotions in psychotherapy dialogues and to explore emotional coherence with larger samples and finer granularity than previously. The present study used state-of-the-art emotion recognition models to automatically label clients' emotions at the utterance level, employed these labeled data to examine the coherence between verbally expressed emotions and self-reported emotions, and examined the associations between emotional coherence and clients' improvement in functioning throughout treatment. The data comprised 872 transcribed sessions from 68 clients. Clients self-reported their functioning before each session and their emotions after each. A subsample of 196 sessions were manually coded. A transformer-based approach was used to automatically label the remaining data for a total of 139,061 utterances. Multilevel modeling was used to assess emotional coherence and determine whether it was associated with changes in clients' functioning throughout treatment. The emotion recognition model demonstrated moderate performance. The findings indicated a significant association between verbally expressed emotions and self-reported emotions. Coherence in clients' negative emotions was associated with improvement in functioning. The results suggest an association between clients' subjective experience and their verbal expression of emotions and underscore the importance of this coherence to functioning. NLP may uncover crucial emotional processes in psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Natural Language Processing , Professional-Patient Relations , Humans , Psychotherapy/methods , Emotions , Expressed Emotion
5.
J Gerontol Nurs ; 50(2): 17-25, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38290096

ABSTRACT

PURPOSE: Research on the concept of expressed emotion (EE) has expanded in recent years but its role in dementia still requires elucidation. Understanding the role of EE in the dementia context could help in the development of appropriate interventions. METHOD: The current review synthesized relevant literature to investigate the prevalence and correlates of EE status in families of people with dementia. A comprehensive search of four databases from inception to 2022 produced 2,683 papers; 18 studies met inclusion criteria. RESULTS: The use of EE criteria differed not only across cultural contexts, but even within the same cultural context. Overall, the prevalence of EE in families with dementia compared with other psychiatric conditions was not high. CONCLUSION: Specific changes in EE over time remain to be explored, and findings emphasize the need to carefully discriminate High EE status based on the cultural background of family members with dementia. [Journal of Gerontological Nursing, 50(2), 17-25.].


Subject(s)
Dementia , Expressed Emotion , Humans , Caregivers/psychology , Family/psychology , Culture
6.
Eat Disord ; 32(2): 153-168, 2024.
Article in English | MEDLINE | ID: mdl-37942724

ABSTRACT

This study examined the effect of pre-treatment levels of parental expressed emotion (EE) on early treatment response for adolescent anorexia nervosa (AN). Data were collected from 121 adolescents, ages 12-18, who met DSM-IV criteria for AN excluding the amenorrhea criterion, and their parents. Participants were randomized to family-based treatment (FBT) or adolescent-focused therapy (AFT). To examine the effects of different thresholds of EE, we used two different levels of EE in analyses. Results demonstrated that adolescents who had at least one parent with elevated EE indicated by a lower threshold (i.e. even mild levels) at baseline were less likely to achieve an early treatment response, suggesting that EE might interfere with treatment success from the start of treatment. When high EE was defined by a higher threshold, these effects were no longer significant, regardless of treatment type (FBT or AFT). These findings suggest that adolescents with AN may be more sensitive to EE than other mental illnesses, such that lower thresholds of EE impact the speed with which they are able to reduce symptoms and gain weight in treatment. It may be necessary to target parental EE prior to or early in treatment or pivot to parent-focused treatment to change the trajectory of treatment response. Future research is needed to explore ways parental EE can be reduced.


Subject(s)
Anorexia Nervosa , Family Therapy , Female , Humans , Adolescent , Family Therapy/methods , Anorexia Nervosa/therapy , Anorexia Nervosa/psychology , Expressed Emotion , Parents/psychology , Treatment Outcome
7.
Emotion ; 24(3): 820-835, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37824223

ABSTRACT

Evidence suggests that Latin Americans display elevated levels of emotional expressivity and positivity. Here, we tested whether Latin Americans possess a unique form of interdependence called expressive interdependence, characterized by the open expression of positive emotions related to social engagement (e.g., feelings of closeness to others). In Study 1, we compared Latin Americans from Chile and Mexico with European Americans in the United States, a group known to be highly independent. Latin Americans expressed positive socially engaging emotions, particularly in response to negative events affecting others, whereas European Americans favored positive socially disengaging emotions, such as pride, especially in response to personally favorable circumstances. Study 2 replicated these findings with another group of Latin Americans from Colombia and European Americans in the United States. Study 2 also included Japanese in Japan, who expressed positive emotions less than Latin and European Americans. However, Japanese displayed a higher tendency to express negative socially engaging emotions, such as guilt and shame, compared to both groups. Our data demonstrate that emotional expression patterns align with overarching ethos of interdependence in Latin America and Japan and independence among European Americans. However, Latin Americans and Japanese exhibited different styles of interdependence. Latin Americans were expressive of positive socially engaging emotions, whereas Japanese were less expressive overall. Moreover, when Japanese expressed emotions, they emphasized negative socially engaging emotions. Implications for theories of culture and emotion are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Cross-Cultural Comparison , Emotions , Humans , United States , Latin America , Emotions/physiology , Expressed Emotion , Japan
8.
Article in English, Portuguese | LILACS, BDENF - Nursing | ID: biblio-1531826

ABSTRACT

Objetivo: identificar o conhecimento e sentimentos de pessoas sobre o cateterismo cardíaco. Método: estudo descritivo, abordagem qualitativa, realizado com 12 pacientes em hospital referência em cardiologia, no município de João Pessoa, no período de novembro a dezembro de 2021. Os dados foram coletados através de entrevista gravada e semiestruturada, os dados analisados pela Análise de Conteúdo de Bardin. Resultados: a partir das entrevistas foram construídas três categorias temáticas: C1 - Conhecimento do procedimento de cateterismo cardíaco, C2 - Falta de orientação dos cuidados que envolvem o cateterismo cardíaco e C3 - Sentimentos à realização do cateterismo cardíaco. Os dados evidenciam um conhecimento insuficiente e limitado que podem se relacionar com o surgimento de sentimentos negativos. Considerações finais: Percebe-se a necessidade de orientações e informações, bem como o planejamento e construção de tecnologias educativas para as pessoas que irão realizar o cateterismo cardíaco, com a finalidade de promover um pré, intra e pós-exame seguro


Objective: to identify people's knowledge and feelings about cardiac catheterization. Method: descriptive study, qualitative approach, carried out with 12 patients in a cardiology reference hospital, in the city of João Pessoa, from November to December 2021. Data were collected through recorded and semi-structured interviews, the data analyzed by Analysis of Bardin content. Results: three thematic categories were constructed from the interviews: C1 - Knowledge of the cardiac catheterization procedure, C2 - Lack of guidance on care involving cardiac catheterization and C3 - Feelings regarding cardiac catheterization. The data highlights insufficient and limited knowledge that may be related to the emergence of negative feelings. Final considerations: There is a perceived need for guidance and information, as well as the planning and construction of educational technologies for people who will undergo cardiac catheterization, with the purpose of promoting a safe pre, intra and post-exam


Objetivos: identificar los conocimientos y sentimientos de las personas sobre el cateterismo cardíaco. Método: estudio descriptivo, de enfoque cualitativo, realizado con 12 pacientes en un hospital de referencia en cardiología, en la ciudad de João Pessoa, de noviembre a diciembre de 2021. Los datos fueron recolectados a través de entrevistas grabadas y semiestructuradas, los datos analizados por Análisis de Bardin contenido. Resultados: a partir de las entrevistas se construyeron tres categorías temáticas: C1 - Conocimiento sobre el procedimiento de cateterismo cardíaco, C2 - Falta de orientación sobre los cuidados relacionados con el cateterismo cardíaco y C3 - Sentimientos respecto al cateterismo cardíaco. Los datos destacan conocimientos insuficientes y limitados que pueden estar relacionados con la aparición de sentimientos negativos. Consideraciones finales: Se percibe la necesidad de orientación e información, así como la planificación y construcción de tecnologías educativas para las personas que serán sometidas a cateterismo cardíaco, con el propósito de promover un pre, intra y post examen seguro


Subject(s)
Cardiac Catheterization , Cardiovascular Nursing , Disinformation , Expressed Emotion
9.
Quad. psicol. (Bellaterra, Internet) ; 26(1): e1972, 2024. tab, graf
Article in Portuguese | IBECS | ID: ibc-232355

ABSTRACT

A comunicação clínica, com foco nas competências emocionais, é uma habilidade que requer treinamento devido à necessidade de reconhecer expressões emocionais dos pacientes e dar uma resposta adequada. O objetivo deste estudo é apresentar uma ferramenta para avaliação da comunicação emocional dos profissionais de saúde, abordando as principais definições teóri-cas sobre a temática e pesquisas baseadas em evidências que aplicaram a ferramenta Codifica-ção de Verona para Sequências Emocionais(VR-CoDES). Baseado numa pesquisa de levantamen-to bibliográfico, o estudo analisa a comunicação emocional dos profissionais de saúde e o uso dessa ferramenta, tendo em vista que a comunicação é a componente chave na alta qualidade do tratamento, com impacto na satisfação e adesão dos pacientes. O estudo discute a impor-tância do reconhecimento de pistas e preocupações emocionais de pacientes em tratamentos de saúde e destaca as lacunas e desafios sobre os treinamentos de habilidades de comunicação emocional nos contextos de saúde. (AU)


Emotional communication in health is a tool to improve communication skills regarding the need to recognize patients’ emotional expressions and give them an adequate response. This study aims to show a tool to assess the emotional communication of health professionals, ad-dressing the main theoretical definitions and evidence-based research that applied the Verona Coding Definitions of Emotional Sequences (VR-CoDES) methodology. Based on bibliographic research, the study analyzes the use of the VR-CoDES on emotional communication of health professionals, considering that communication is the key component in the high quality of treatment, with an impact on patient satisfaction and compliance. The study discusses the importance of recognizing patients’ emotional cues and concerns in health care and highlights the gaps and challenges in training emotional communication skills in health contexts. (AU)


Subject(s)
Humans , Communication , Health Personnel , Expressed Emotion , Emotions , Healthcare Common Procedure Coding System
10.
PLoS One ; 18(11): e0280103, 2023.
Article in English | MEDLINE | ID: mdl-38011136

ABSTRACT

BACKGROUND: 'Expressed Emotion (EE)' captures ways in which emotions are expressed within a family environment. Research has found that EE in families has an impact on psychiatric illness, in particular psychosis, such that it increases risk of relapse. EE was conceptualised by research conducted in the UK. Thus, behaviours defined as pathological were largely based on white samples adhering to UK norms. Cross-cultural variations have been found in EE and its relationship with clinical outcomes. A more culturally appropriate understanding of norms surrounding the EE across cultures is required. AIMS: This study aims to use a bottom-up approach to provide a culturally specific understanding of family relationships and EE across 'non-clinical' UK-based South Asian families. METHODS: Semi-structured interviews were conducted with 18 South Asian participants to explore their relationships with a significant other. Interviews were analysed using thematic analysis. RESULTS: Four main themes were generated: expression of love, setting boundaries, inter-generational differences and acceptance. CONCLUSION: The findings indicate considerable cultural variability within EE and highlight the need to interpret EE in the context of socio-cultural norms. Whilst certain domains of EE that are considered pathological in Western contexts are present in the UK-based South Asian diaspora, these are perceived as less problematic, indicative of varying cultural norms.


Subject(s)
Expressed Emotion , Psychotic Disorders , Humans , Psychotic Disorders/psychology , Qualitative Research , Emotions , United Kingdom
11.
Turk Psikiyatri Derg ; 34(3): 145-153, 2023.
Article in English, Turkish | MEDLINE | ID: mdl-37724640

ABSTRACT

OBJECTIVE: The aim of this study was to qualitatively examine Turkish tweets about schizophrenia in respect of stigmatization and discrimination within a one-month period and to conduct emotional analysis using artificial intelligence applications. METHOD: Using the keyword 'schizophrenia,' Turkish tweets were gathered from the Python Tweepy application between December 19, 2020 and January 18, 2021. Features were extracted using the Bidirectional Encoder Representations from Transformers (BERT) method and artificial neural networks and tweets were classified as positive, neutral, or negative. Approximately 5% of the tweets were qualitatively analyzed, constituting those most frequently liked and retweeted. RESULTS: The study found that, of the total of 3406 schizophreniarelated messages shared in Turkey over a period of one-month, 2996 were original, and were then retweeted a total of 1823 times, and liked by 25,413 people. It was determined that 63.4% of the tweets shared about schizophrenia contained negative emotions, 28.7% were neutral, and 7.71% expressed positive emotions. Within the scope of the qualitative analysis, 145 tweets were examined and classified under four main themes and two sub-themes; namely, news about violent patients, insult (insulting people in interpersonal relationships, insulting people in the news), mockery, and information. CONCLUSION: The results of this study showed that the Turkish tweets about schizophrenia, which were emotionally analyzed using artificial intelligence were found often to contain negative emotions. It was also seen that Twitter users used the term schizophrenia, not in a medical sense but to insult and make fun of individuals, frequently shared the news that patients were victims or perpetrators of violence, and the messages shared by professional branch organizations or mental health professionals were primarily for conveying information to the public.


Subject(s)
Artificial Intelligence , Schizophrenia , Humans , Sentiment Analysis , Turkey , Expressed Emotion
12.
Multimedia | Multimedia Resources | ID: multimedia-11170

ABSTRACT

Actividades para tener una semana de bienestar.


Subject(s)
Psychological Well-Being , Mental Health , Expressed Emotion
13.
Sci Rep ; 13(1): 11141, 2023 07 10.
Article in English | MEDLINE | ID: mdl-37429942

ABSTRACT

Living in high expressed emotion (EE) environments tends to increase the relapse rate in schizophrenia (SZ). At present, the neural substrates responsible for high EE in SZ remain poorly understood. Functional near-infrared spectroscopy (fNIRS) may be of great use to quantitatively assess cortical hemodynamics and elucidate the pathophysiology of psychiatric disorders. In this study, we designed novel low- (positivity and warmth) and high-EE (criticism, negative emotion, and hostility) stimulations, in the form of audio, to investigate cortical hemodynamics. We used fNIRS to measure hemodynamic signals while participants listened to the recorded audio. Healthy controls (HCs, [Formula: see text]) showed increased hemodynamic activation in the major language centers across EE stimulations, with stronger activation in Wernicke's area during the processing of negative emotional language. Compared to HCs, people with SZ ([Formula: see text]) exhibited smaller hemodynamic activation in the major language centers across EE stimulations. In addition, people with SZ showed weaker or insignificant hemodynamic deactivation in the medial prefrontal cortex. Notably, hemodynamic activation in SZ was found to be negatively correlated with the negative syndrome scale score at high EE. Our findings suggest that the neural mechanisms in SZ are altered and disrupted, especially during negative emotional language processing. This supports the feasibility of using the designed EE stimulations to assess people who are vulnerable to high-EE environments, such as SZ. Furthermore, our findings provide preliminary evidence for future research on functional neuroimaging biomarkers for people with psychiatric disorders.


Subject(s)
Schizophrenia , Humans , Schizophrenia/diagnostic imaging , Expressed Emotion , Spectrum Analysis , Emotions , Euphoria
14.
Physiol Behav ; 269: 114276, 2023 10 01.
Article in English | MEDLINE | ID: mdl-37364671

ABSTRACT

Families can express high criticism, hostility and emotional over-involvement towards a person with or at risk of mental health problems. Perceiving such high expressed emotion (EE) can be a major psychological stressor for individuals, especially those at risk of mental health problems. To reveal the biological mechanisms underlying the effect of EE on health, this study investigated physiological response (salivary cortisol, frontal alpha asymmetry (FAA)) to verbal criticism and their relationship to anxiety and perceived EE. Using a repeated-measures design, healthy participants attended three testing sessions on non-consecutive days. On each day, participants listened to one of three types of auditory stimuli, namely criticism, neutral or praise, and Electroencephalography (EEG) and salivary cortisol were measured. Results showed a reduction in cortisol following criticism but there was no significant change in FAA. Post-criticism cortisol concentration negatively correlated with perceived EE after controlling for baseline mood. Our findings suggest that salivary cortisol change responds to criticism in non-clinical populations and this response might be largely driven by individual differences in the perception of criticism (e.g., arousal and relevance). Criticisms expressed by audio comments may not be explicitly perceived as an acute emotional stressor, and thus, physiological response to criticisms could be minimum.


Subject(s)
Expressed Emotion , Hydrocortisone , Humans , Expressed Emotion/physiology , Emotions/physiology , Anxiety/psychology , Electroencephalography
15.
Ann Behav Med ; 57(9): 753-764, 2023 08 21.
Article in English | MEDLINE | ID: mdl-37178456

ABSTRACT

BACKGROUND: The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment. PURPOSE: The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment. METHODS: At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later. RESULTS: Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up. CONCLUSIONS: Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.


Cancer is a stressful experience for patients and their partners. We know that how couples communicate about cancer is important, but we do not know much about how couples express emotion during cancer conversations and how those emotional expressions affect well-being. Our study looked at how couples' emotional arousal within cancer conversations relate to individual and relationship well-being. At the beginning of the study, cancer patients and their partners had a conversation about cancer. Within these conversations, we tracked the emotional arousal expressed in their voices. Couples also completed surveys about their well-being at the beginning of the study and later in time (4, 8, and 12 months later). We found that couples who started the conversation with higher emotional arousal had better initial well-being. Couples who remained higher in arousal later in the conversation improved in their individual well-being over time. We also found that if the non-cancer partner was low in arousal compared with patients, this predicted worse well-being over time. More research is needed, but these findings suggest that being emotionally aroused during conversations about important topics like cancer might be helpful for well-being, potentially because couples are discussing concerns and not backing off when it feels challenging.


Subject(s)
Arousal , Communication , Emotional Adjustment , Expressed Emotion , Family Characteristics , Family Relations , Neoplasms , Adult , Aged , Female , Humans , Male , Middle Aged , Family Relations/psychology , Follow-Up Studies , Neoplasms/psychology , Resilience, Psychological , Sound Recordings , Voice , Family Support/psychology
16.
Pan Afr Med J ; 44: 11, 2023.
Article in French | MEDLINE | ID: mdl-37013210

ABSTRACT

Introduction: expressed emotion (EE) is a concept which dates back to the sixties and refers to the attitude that relatives have toward a family member with schizophrenia. It comprises three behavioral patterns: criticism, hostility, and emotional overinvolvement. An important body of literature has shown that high expressed emotion (EE) is a factor of relapse in schizophrenia. The purpose of our study was to measure expressed emotion in the families of a Moroccan sample of patients and then to investigate factors associated with high EE. Methods: fifty (50) patients with stable schizophrenia, each with a relative involved in their care, were recruited during outpatients visits. Sociodemographic data were collected and the FAS scale was used by relatives. Data were also collected from the mental representations of relatives about the patient and disease. Statistical analysis was carried out using the SPSS software and was based on the Chi 2 tests as well as T tests for independent samples. Results: forty-eight percent (48%) of relatives had a high EE. High EE was associated with a feeling of shame toward the patient. It was also associated with cannabis addiction. Low EE was associated with the fact that the patient financially took care of his family. Conclusion: the knowledge of the determinants of high EE in our socio-cultural context is essential in order to direct any psycho-educational intervention aimed at reducing EE.


Subject(s)
Schizophrenia , Humans , Cross-Sectional Studies , Expressed Emotion , Family/psychology , Hostility
17.
Schizophr Res ; 255: 203-212, 2023 05.
Article in English | MEDLINE | ID: mdl-37004332

ABSTRACT

BACKGROUND: Family members, who provide the majority of informal care during the recovery period from first-episode psychosis (FEP), experience high levels of psychological distress. However, there is a lack of effective and accessible interventions for FEP carers. OBJECTIVE: To determine the effectiveness of an online intervention ("Altitudes") in relation to the primary outcome of FEP-carer stress at 6 months follow-up. METHODS: We conducted a cluster randomized controlled trial in which FEP carers were randomized to Altitudes combined with specialized treatment as usual (STAU) or STAU alone. In addition to questionnaires, we included multiple waves of intensive ecological momentary assessment (EMA) to measure carer stress and family outcomes in 164 carers of young (15-27 years) FEP patients. RESULTS: Both groups improved over time on stress and a range of secondary outcomes, including mental health symptoms, self-efficacy, and expressed emotion with no group by time interactions. At 12 months there were significantly fewer visits to emergency departments by FEP patients in the Altitudes group (p = 0.022). Modelling of multiple EMA waves revealed that more time spent by carers with FEP patients predicted greater worry, expressed emotion, and adaptive coping. CONCLUSIONS: Engagement and usability findings for Altitudes were positive. Further refinements to our online carer interventions may be needed to engage carers in purposeful skill development for improved management of stress and communication with the young person compared with existing specialist family interventions. TRIAL REGISTRATION: ACTRN12616000968471.


Subject(s)
Caregivers , Psychotic Disorders , Humans , Adolescent , Caregivers/psychology , Psychotic Disorders/psychology , Adaptation, Psychological , Mental Health , Expressed Emotion
18.
Br J Clin Psychol ; 62(2): 431-443, 2023 Jun.
Article in English | MEDLINE | ID: mdl-36840348

ABSTRACT

OBJECTIVES: Dementia is a growing health concern. Persons with dementia experience higher levels of anxiety and depression, which correlates with poorer quality of life, disability and hospitalization. This is one of the few studies to use a longitudinal design to assess the impact of expressed emotion (EE) on well-being in dementia over time. METHODS: Sixty-one people with dementia and their main informal caregiver were recruited from memory services. Caregiver EE was coded from a Camberwell Family Interview conducted at time one. Person with dementia's outcome measures (quality of life, depression and anxiety) were collected at time one and at 6-months follow-up. RESULTS: Caregiver high EE was associated with higher levels of depression in people with dementia and greater anxiety at follow-up. Emotional over involvement predicted greater anxiety and critical comments predicted greater depression. Low EE appeared to have a protective effect on well-being in people with dementia. People with dementia with low EE caregivers experienced a small reduction in depression and anxiety over time, whereas those with high-EE caregivers maintained baseline levels of depression and anxiety. CONCLUSIONS: Caregiver high EE is associated with poorer psychological outcomes for people with dementia over time. Psychological therapies, such as cognitive behavioural therapy informed family interventions should be used to reduce high EE within carer and person with dementia relationships.


Subject(s)
Caregivers , Dementia , Humans , Caregivers/psychology , Quality of Life , Psychological Well-Being , Expressed Emotion , Dementia/psychology , Depression
19.
Sensors (Basel) ; 23(4)2023 Feb 17.
Article in English | MEDLINE | ID: mdl-36850850

ABSTRACT

A Brain-Computer Music Interface (BCMI) system may be designed to harness electroencephalography (EEG) signals for control over musical outputs in the context of emotionally expressive performance. To develop a real-time BCMI system, accurate and computationally efficient emotional biomarkers should first be identified. In the current study, we evaluated the ability of various features to discriminate between emotions expressed during music performance with the aim of developing a BCMI system. EEG data was recorded while subjects performed simple piano music with contrasting emotional cues and rated their success in communicating the intended emotion. Power spectra and connectivity features (Magnitude Square Coherence (MSC) and Granger Causality (GC)) were extracted from the signals. Two different approaches of feature selection were used to assess the contribution of neutral baselines in detection accuracies; 1- utilizing the baselines to normalize the features, 2- not taking them into account (non-normalized features). Finally, the Support Vector Machine (SVM) has been used to evaluate and compare the capability of various features for emotion detection. Best detection accuracies were obtained from the non-normalized MSC-based features equal to 85.57 ± 2.34, 84.93 ± 1.67, and 87.16 ± 0.55 for arousal, valence, and emotional conditions respectively, while the power-based features had the lowest accuracies. Both connectivity features show acceptable accuracy while requiring short processing time and thus are potential candidates for the development of a real-time BCMI system.


Subject(s)
Brain-Computer Interfaces , Music , Humans , Expressed Emotion , Emotions , Arousal
20.
JBI Evid Synth ; 21(4): 789-795, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36730284

ABSTRACT

OBJECTIVE: The objective of this review is to evaluate the effectiveness of internet-based psychosocial interventions versus active comparators (such as in-person interventions, bibliotherapy, or telephone interventions) and passive comparators (such as usual psychiatric care) on psychological distress, expressed emotion, and knowledge about psychosis in family caregivers of people with schizophrenia. INTRODUCTION: Family caregivers of individuals with schizophrenia are at increased risk of developing mental disorders. Despite the widespread dissemination of reliable guidelines for caring for people with schizophrenia and their family caregivers, these have been poorly implemented. Hence, internet-based interventions with caregivers of people with schizophrenia could be an effective and feasible option. INCLUSION CRITERIA: This review will include studies focusing on the family caregivers of individuals diagnosed with schizophrenia. Internet-based psychosocial interventions will be defined as any psychosocial intervention that is internet-based compared with active comparators (such as in-person interventions, bibliotherapy, or telephone interventions) and passive comparators (such as usual psychiatric care). The primary outcomes of this review will include psychological distress, expressed emotion, and knowledge about the psychosis of family caregivers of people with schizophrenia. The secondary outcome will be the hospitalization of people with schizophrenia. METHODS: MEDLINE (PubMed), CINAHL (Ovid), Scopus, Cochrane Library, and ProQuest Dissertations and Theses will be systematically searched for published and unpublished studies from 2010 in English and Thai. Two reviewers will select studies, critically appraise them, and perform data extraction independently. Finally, when possible, the studies will be pooled through statistical meta-analysis and grading of the certainty of evidence by each outcome. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021255318.


Subject(s)
Internet-Based Intervention , Psychological Distress , Psychotic Disorders , Schizophrenia , Humans , Schizophrenia/therapy , Caregivers/psychology , Psychosocial Intervention , Expressed Emotion , Psychotic Disorders/therapy , Systematic Reviews as Topic , Meta-Analysis as Topic
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