This study examined the relationship between maternal expressed emotion (EE) and children's perceived self-competence, behavior and intelligence in a community sample of 190 urban, African American children ages 6-7. Maternal EE was measured by the Five Minute Speech Sample. Self reports and standardized measures were used to examine other mother and child variables. Compared with Low EE, High EE was associated with children's decreased cognitive self-concept, increased anxiety, and greater levels of hyperactivity. EE was unrelated to children's intelligence. The study suggests that for African American children at early school age, maternal EE predicts child anxiety, perceived cognitive competence, and hyperactive behavior. Further investigation appears warranted to evaluate the relationship, over time, between EE and child outcomes.

This study aimed to examine relative effect of perceived expressed emotion of schizophrenic patients and their caregivers&rsquo / expressed emotion on the symptom severity and quality of life at the framework of Vulnerability-Stress Model. Before the main study, for evaluating the psychometric properties of the Perceived Expressed Emotion Scale (PEES) a pilot study was conducted with the seventy five patients. Results of the pilot study provided support for the reliability and validity of PEES that had two factors, namely, criticism/hostility and emotional over-involvement. The main study was conducted at two stages. At time one assessment, one hundred and sixteen patients were administered PEES, Positive and Negative Symptom Scale for schizophrenia (PANSS), WHO&rsquo / s Quality of Life Scale (WHOQOL-BREF), and open ended questions to explore the views about their illness. Their caregivers were administered Expressed Emotion Scale (EES). After six month follow up, time two assessment was conducted 103 patients remained on the study using PANSS and WHOQOL-BREF. In order to test the main hypothesis of the study a series of repeated ANOVA analyses were conducted. The results revealed that patients&rsquo / perceived expressed emotion was a more robust component on quality of life and symptom severity than caregivers&rsquo / expressed emotion. It was found that patients&rsquo / perceived criticism/hostility was a toxic element on positive and negative symptoms, and total scores of PANSS, whereas patients&rsquo / perceived emotional over-involvement had a protector effect on social and environmental domain of standardized culture of WHOQOL-BREF. It was seen that symptom severity evaluated using PANSS improved from time one assessment to time two assessment. After discussing the findings in the framework of the literature, the limitations and the clinical implications of the results and directions for future studies were suggested.

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Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-08T14:16:48Z No. of bitstreams: 1 Paula Isabella Marujo Nunes da Fonseca.pdf: 8021393 bytes, checksum: db9ec4e08561cc9971f856e2cb492cb3 (MD5) / Made available in DSpace on 2015-12-08T14:16:48Z (GMT). No. of bitstreams: 1 Paula Isabella Marujo Nunes da Fonseca.pdf: 8021393 bytes, checksum: db9ec4e08561cc9971f856e2cb492cb3 (MD5) Previous issue date: 2013 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Estudo trata das emoções vivenciadas pelas equipes multiprofissionais da Central de Transplantes do estado do Rio de Janeiro na entrevista familiar para doação de órgão(s). Após certificação do quadro de morte encefálica, os profissionais da Central de Transplantes buscam comunicação com os familiares sobre o diagnóstico final do potencial doador através da entrevista familiar, momento que envolve grande carga emocional. Diante disso objetivou-se: Caracterizar as emoções vivenciadas pelos profissionais de saúde na entrevista familiar para doação de órgão(s); Analisar o manejo das emoções vivenciadas por estes profissionais na entrevista familiar; e, Discutir medidas para educação emocional dos profissionais entrevistadores. O método utilizado foi da abordagem qualitativa, sendo o estudo do tipo descritivo- interpretativo. Como técnica de pesquisa para coleta dos dados dos 24 sujeitos, acontecida entre jan/maio de 2012, foi aplicado questionário sócio cultural, seguido de entrevista semi estruturada, e posteriormente foram coletados os dados expressivos através da Técnica da Imaginação Ativa proposta por C.G. Jung. O estudo foi submetido ao Comitê de Ética do HUAP/UFF, onde obteve aprovação sob o nº321/11, respeitando a Resolução 466/2012 que trata de pesquisas com seres humanos. Resultados. Dados sócio-culturais: a maioria dos sujeitos são do sexo feminino, possuem média etária de 38,7 anos; 12 coordenadores atuam na instituição entre 2 e 3 anos, e somente 4 desenvolvem esta atividade há mais de 10 anos, sendo estes últimos servidores de vínculo estatutário; 23 destes profissionais possuem outro vínculo empregatício com cargas horárias que variam de 20h à 72,5h/semanais; e, 17 destes profissionais são enfermeiros. Dados da entrevista principal: observou-se grande dificuldade dos sujeitos em caracterizarem suas emoções, as tendo representado de outras maneiras, através de sentimentos, impressões, ações e até sinais físicos. Os sujeitos que rememoraram suas lembranças emocionais relacionadas às situações difíceis vivenciadas na entrevista familiar identificaram: raiva, medo, tristeza e amor. Em relação às características de emoções, surgiram: pavor, nervosismo e angústia (característica do Medo); e, irritação (característica da Raiva); felicidade (característica emocional da Alegria) e satisfação (característica emocional do Prazer). Em relação ao manejo das emoções emergiram: a questão do choro como meio de enfrentamento/alívio; A empatia e suas conseqüências emocionais; e, A projeção do que está por vir, que representam as projeções situacionais que geram benefícios para si ou para os outros. Dados da produção expressiva evidenciaram que através de símbolos culturais como lágrimas, sol e o coração, os sujeitos que não conseguiram assumir ou reconhecer suas emoções ao longo dos depoimentos, conseguiram expor o que lhes afetam na entrevista familiar. Discute-se como meio de educação emocional, um serviço de suporte emocional para que se trabalhe o autoconhecimento dos sujeitos afim de que estes identifiquem através deste processo as melhores medidas para enfrentarem as situações difíceis. Conclui-se que investir no autoconhecimento dos sujeitos pode lhes proporcionar mais qualidade no trabalho e na vida pessoal amortizando os danos a sua saúde mental. / It treats about a study of emotions experienced by multidisciplinary teams of Transplant Center of the State of Rio de Janeiro in the family interview for organ donation (s). After certification of brain death, the professionals at the Transplant Center seek communication with family members about the final diagnosis of the potential donor through family interview, moment that involving a big emotionally charged. Therefore this study aimed to: characterize the emotions experienced by health professionals in family interview for Organ Donation(s); Analyze the management of emotions experienced by these professionals in the family interview; and Discuss measures for emotional education for the interviewers. The method used was the qualitative approach, and the study is descriptive-interpretative type . As a research technique to collect data from 24 subjects, between Jan / May 2012, was used a sociocultural survey, followed by semi -structured interview. Subsequently was applied the Active Imagination Technique proposed by CG Jung. The study was submitted to the Ethics Committee of the HUAP / UFF , which was approved under No. 321/11 , subject to Resolution 466/2012 which deals with human research . Results. Socio- cultural data: most subjects are female , have an average age of 38.7 years, 12 coordinators working in the institution between 2 and 3 years, and only 4 developed this activity for more than 10 years, the latter being servers statutory bond; 23 of these professionals have other employment with workloads ranging from 20h to 72.5h/week , and 17 of these professionals are nurses. Data from the main interview: there was great difficulty in characterizing subjects of their emotions, and represented in other ways, through feelings, impressions, actions and even physical signs. Subjects who recalled their emotional memories related to difficult situations experienced in family interview identified: anger, fear , sadness and love . Regarding the characteristics of emotions emerged: fear , nervousness and anxiety (characteristic of Fear ), and irritation ( characteristic of Anger), happiness (emotional characteristic of Joy) and satisfaction (emotional characteristic of Pleasure). Regarding the management of emotions emerged: the issue of crying as a means of coping/relief; Empathy and its emotional consequences, and the projection of what is to come , representing the situational projections that generate benefits for hemselves or others. Data showed that the impressive output through cultural symbols such as tears, sun and heart, the subjects who failed to assume or acknowledge their emotions over the testimony, managed to expose that affect them in the family interview . It is discussed as a means of emotional education , a service of emotional support in order to work the self-knowledge of the subject in order that through this process they identify the best measures to cope with difficult situations. Conclusion: Invest in self-knowledge for the subjects can provide them with better quality in work and personal life amortizing damage in your mental health.

Expressed emotion (EE), the affective attitudes and behaviors of one toward another, can affect caregivers’ behaviors toward their child. Research examining associations between EE and child/family outcomes is mixed; these associations may be affected by other influences such as the presence of a chronic disease or parent mental health. In this study of families living in an urban area, we examined associations between EE and child outcomes (anxiety/depressive symptoms) and family functioning, with parent anxiety as a covariate. We evaluated child asthma status as a moderator as the presence of a chronic illness may strengthen the association between EE and child/family outcomes. Ninety-four children (mean±SD age=8.83±2.03 years, 48.9% female, 92.6% African American; 47 with asthma) and their parents (81.3% annual household income less than $25,000) completed an observational study including interviews and questionnaires. Measures included the Multidimensional Anxiety Scale for Children (MASC), Children’s Depressive Symptoms Inventory (CDI), Self-Report Family Inventory (SFI), Generalized Anxiety Disorder scale (GAD-7), and Five-Minute Speech Sample (FMSS) coded for EE. To examine study aims, regression analyses were conducted using PROCESS macro version 3.4. Asthma status (yes/no) was examined as a moderator. EE was associated with child anxiety symptoms, controlling for parent anxiety symptoms (F(1,70) =7.67, p=0.007). Criticism was also positively associated with asthma control (F(1,39)=4.33, p=.04, R2=.08). Asthma status did not moderate any of the associations. Results suggested that high levels of caregiver EE were associated with child anxiety symptoms, but asthma status did not moderate associations. It is possible that regardless of additional family demands related to asthma, EE is associated with child anxiety. Further examination into other systemic stressors (e.g., poverty, access to care) that may moderate these associations is warranted, as well as the impact that minimizing parent anxiety might have on overall EE.

INTRODUÇÃO: O sucesso do tratamento de dependentes de álcool e outras drogas numa comunidade terapêutica (CT) depende fundamentalmente da adesão ao tratamento, ou seja, o tempo de permanência na comunidade. Sabe-se que pacientes que permanecem em tratamento por um período de pelo menos três meses têm uma evolução melhor do que aqueles que abandonam o tratamento precocemente. O ambiente emocional familiar tem grande influência na adesão ao tratamento, e pode ser medido por meio da emoção expressa EE). MÉTODOS: Foram avaliados familiares de 31 dependentes de substâncias psicoativas e/ou de álcool, internados involuntariamente, por meio da versão abreviada e traduzida para o português da Entrevista Familiar de Camberwell (EFC). A partir de então, mediu-se a taxa de permanência na CT após seis, 12 e 18 meses. Foram avaliados os aspectos hostilidade, superenvolvimento e calor afetivo. A hostilidade foi abordada como ausente (pontuação igual a zero) ou presente (pontuação igual a 1, 2 ou 3). O superenvolvimento e o calor afetivo foram considerados de forma contínua (pontuação de zero a 5) e categorizada. Todos os possíveis pontos de corte foram estudados na procura de novas relações e significados dos componentes da EE para esta população específica e os achados da amostra. RESULTADOS: Foram considerados com alta EE para hostilidade 41,9% dos familiares entrevistados e 71% para superenvolvimento emocional; 25,8% destes familiares pontua ram para ambos os componentes da EE (hostilidade e superenvolvimento). Dos 31 pacientes, cinco (16,1%) desistiram do tratamento até os seis meses; dois pacientes desistiram entre o 6 o e o 12 o mês (25% de desistência em 12 meses) e quatro abandonaram o tratamento entre o 12 o e o 18 o mês (47,8% de abandono em 18 meses). Houve uma associação significativa entre a presença de hostilidade e o abandono do tratamento antes dos seis meses (p = 0,008, teste exato de Fischer). Houve diferença significativa na frequência de superenvolvimento familiar entre o grupo que permaneceu 18 meses e o grupo que abandonou o tratamento (p = 0,037, teste de Mann-Whitney). Os pacientes que permanceram em tratamento até os 18 meses tiveram uma freqüência maior de familiares com alto nível de superenvolvimento familiar (> 4) (p = 0,012; teste exato de Fisher). Não houve nenhuma associação entre o tempo de permanência e o calor afetivo. CONCLUSÕES: Alta EE tem influência significativa sobre o tempo de permanência do dependente químico ou de álcool na CT. A presença de hostilidade foi mais freqüente no grupo com o abandono prematuro do tratamento, enquanto o alto superenvolvimento do familiar foi mais freqüente no grupo de pacientes que permaneceu em tratamento até os 18 meses. Estudos com uma população maior são necessários para apoiar esses achados. / BACKGROUND: The success of treatment for alcohol and other substance dependence in a therapeutic community (TC) depends greatly on the treatment adherence, i.e., the length of stay at the TC. It is well known that subjects who stay on treatment for ate least three months have a better outcome, compared with those who early withdraw. The family emotional environment can be measured through expressed emotion (EE) and has great influence on treatment adherence. METHODS: 31 key-relatives of alcoholics and other substance dependents, who involuntarily began a treatment in a TC, were assessed through the Camberwell Family Interview (CFI) (shorter translated to Portuguese version). The proportion of subjects who remained on treatment in the TC was then measured after six, 12 and 18 months. Evaluated aspects included hostility, overinvolvement and warmth. Hostility was assessed as absent (score = 0) or present (score = 1, 2 or 3). Overinvolvement and warmth were considered as continuous and categorized values (scores 0 to 5). Every possible cutoff points were studied, in order to find new associations and meanings of EE components of this specific population and the length pf stay in a TC. RESULTS: 41.9% of the relatives were considered as having high EE for hostility and 71% for overinvolvement; among those relatives with high EE, 25.8% had presence for both hostility and overinvolvement. Among the 31 patients, five (16.1%) abandoned treatment up to 6 months; 2 patients abandoned treatment between 6th and 12th month (25% treatment abandon in 12 months) and four abandoned the treatment between 12th and 18th month (47.8% treatment abandon at 18 months). There was a significant higher frequency of presence of hostility in the group that abandoned before six months (p = 0.008, Fischer exact test). A significant difference of familiar overinvolvement was found between the group who remained in the treatment up to 18 months and the group that abandoned treatment earlier (p = 0.037, Mann-Whitney test). Families with score = 4 for overinvolvement were more frequent in the group that remained on treatment up to 18 months (p = 0.0012; Fischer exact test). No correlation was found between warmth and length of stay at TC. CONCLUSIONS: High EE has a significant influence over the length of stay of the alcoholic or other substance dependent in a TC. The presence of hostility is more frequent among families of patients who prematurely abandon treatment, while higher score of overinvolvement was more frequent in the families of the group that completed 18 months of treatment in the TC. Further studies with larger population are needed to support those findings.

<p>This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period.</p><p>A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis.</p><p>Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders.</p><p>Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine. </p><p>Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment.</p><p>Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.</p>

This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period. A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis. Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders. Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine. Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment. Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.

This study aimed to examine the quality of life (QOL) and well-being of haemodialysis patients and the relationship of two components of perceived expressed emotion (criticism/hostility and emotional over-involvement) and other psychosocial resources within the Conservation of Resources Model. Demographic variables and haemodialysis related information of patients, classified as resources, were also included in the study. One hundred and six haemodialysis patients voluntarily participated in the study. Before the main study, for evaluating the psychometric properties of the Symptom Distress Scale (SDS), Coping Self-Efficacy Scale (CSES), and Perceived Expressed Emotion Scale (PEES) a pilot study was conducted with the fifty-three haemodialysis patients. Results of the pilot study provided support for the reliability and validity of scales. For the main study, optimism, self-esteem, and perceived social support were taken as resources and were also included as measures. In order to test the main hypothesis of the studies a series of regression analyses were conducted. The results of the analysis revealed that predictors of well-being were age, self esteem, criticism/hostility factor of perceived expressed emotion and coping self-efficacy / predictors of physical health component of QOL were age, education, presence of additional diagnosis, and coping self-efficacy. Moreover, it was found that predictors of mental health component of QOL were the presence of additional diagnosis and coping self-efficacy / and predictors of the mean score of QOL were age, presence of additional diagnosis, self-esteem, and coping self-efficacy. Directions of the relationship between age, education, presence of additional diagnosis, and criticism/hostility were negative with the outcome variables, whereas, directions of the relationship between self-esteem and coping self-efficacy were positive with the outcome variables. The mediational role of coping self-efficacy in the association between resources and outcome variables were also investigated. Mediator effect of coping self-efficacy was found only for two variables. Firstly, the effect of duration of haemodialysis treatment was mediated by the coping self-efficacy for the well being measure. Second, coping self-efficacy carries the influence of the family income to the mean score of QOL. After discussing the findings of the present study in the light of the literature, the limitations and the clinical implications of the results and directions for the future studies were suggested.

INTRODUÇÃO: O sucesso do tratamento de dependentes de álcool e outras drogas numa comunidade terapêutica (CT) depende fundamentalmente da adesão ao tratamento, ou seja, o tempo de permanência na comunidade. Sabe-se que pacientes que permanecem em tratamento por um período de pelo menos três meses têm uma evolução melhor do que aqueles que abandonam o tratamento precocemente. O ambiente emocional familiar tem grande influência na adesão ao tratamento, e pode ser medido por meio da emoção expressa EE). MÉTODOS: Foram avaliados familiares de 31 dependentes de substâncias psicoativas e/ou de álcool, internados involuntariamente, por meio da versão abreviada e traduzida para o português da Entrevista Familiar de Camberwell (EFC). A partir de então, mediu-se a taxa de permanência na CT após seis, 12 e 18 meses. Foram avaliados os aspectos hostilidade, superenvolvimento e calor afetivo. A hostilidade foi abordada como ausente (pontuação igual a zero) ou presente (pontuação igual a 1, 2 ou 3). O superenvolvimento e o calor afetivo foram considerados de forma contínua (pontuação de zero a 5) e categorizada. Todos os possíveis pontos de corte foram estudados na procura de novas relações e significados dos componentes da EE para esta população específica e os achados da amostra. RESULTADOS: Foram considerados com alta EE para hostilidade 41,9% dos familiares entrevistados e 71% para superenvolvimento emocional; 25,8% destes familiares pontua ram para ambos os componentes da EE (hostilidade e superenvolvimento). Dos 31 pacientes, cinco (16,1%) desistiram do tratamento até os seis meses; dois pacientes desistiram entre o 6 o e o 12 o mês (25% de desistência em 12 meses) e quatro abandonaram o tratamento entre o 12 o e o 18 o mês (47,8% de abandono em 18 meses). Houve uma associação significativa entre a presença de hostilidade e o abandono do tratamento antes dos seis meses (p = 0,008, teste exato de Fischer). Houve diferença significativa na frequência de superenvolvimento familiar entre o grupo que permaneceu 18 meses e o grupo que abandonou o tratamento (p = 0,037, teste de Mann-Whitney). Os pacientes que permanceram em tratamento até os 18 meses tiveram uma freqüência maior de familiares com alto nível de superenvolvimento familiar (> 4) (p = 0,012; teste exato de Fisher). Não houve nenhuma associação entre o tempo de permanência e o calor afetivo. CONCLUSÕES: Alta EE tem influência significativa sobre o tempo de permanência do dependente químico ou de álcool na CT. A presença de hostilidade foi mais freqüente no grupo com o abandono prematuro do tratamento, enquanto o alto superenvolvimento do familiar foi mais freqüente no grupo de pacientes que permaneceu em tratamento até os 18 meses. Estudos com uma população maior são necessários para apoiar esses achados. / BACKGROUND: The success of treatment for alcohol and other substance dependence in a therapeutic community (TC) depends greatly on the treatment adherence, i.e., the length of stay at the TC. It is well known that subjects who stay on treatment for ate least three months have a better outcome, compared with those who early withdraw. The family emotional environment can be measured through expressed emotion (EE) and has great influence on treatment adherence. METHODS: 31 key-relatives of alcoholics and other substance dependents, who involuntarily began a treatment in a TC, were assessed through the Camberwell Family Interview (CFI) (shorter translated to Portuguese version). The proportion of subjects who remained on treatment in the TC was then measured after six, 12 and 18 months. Evaluated aspects included hostility, overinvolvement and warmth. Hostility was assessed as absent (score = 0) or present (score = 1, 2 or 3). Overinvolvement and warmth were considered as continuous and categorized values (scores 0 to 5). Every possible cutoff points were studied, in order to find new associations and meanings of EE components of this specific population and the length pf stay in a TC. RESULTS: 41.9% of the relatives were considered as having high EE for hostility and 71% for overinvolvement; among those relatives with high EE, 25.8% had presence for both hostility and overinvolvement. Among the 31 patients, five (16.1%) abandoned treatment up to 6 months; 2 patients abandoned treatment between 6th and 12th month (25% treatment abandon in 12 months) and four abandoned the treatment between 12th and 18th month (47.8% treatment abandon at 18 months). There was a significant higher frequency of presence of hostility in the group that abandoned before six months (p = 0.008, Fischer exact test). A significant difference of familiar overinvolvement was found between the group who remained in the treatment up to 18 months and the group that abandoned treatment earlier (p = 0.037, Mann-Whitney test). Families with score = 4 for overinvolvement were more frequent in the group that remained on treatment up to 18 months (p = 0.0012; Fischer exact test). No correlation was found between warmth and length of stay at TC. CONCLUSIONS: High EE has a significant influence over the length of stay of the alcoholic or other substance dependent in a TC. The presence of hostility is more frequent among families of patients who prematurely abandon treatment, while higher score of overinvolvement was more frequent in the families of the group that completed 18 months of treatment in the TC. Further studies with larger population are needed to support those findings.