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Expressed Emotion and the Double-Bind: Communication of Specific Emotions in Schizophrenia
Unformatted Document Text:  Page 15 Discussion Major Findings. Emotional experience and expression. It appears that Schizophrenia participants rated themselves as feeling slightly to moderately less appropriately relative to Comparison persons, as they were relatively more negative on the conventionally positive Familiar Experimenter slide. However, Schizophrenia participants clearly distinguished between the slides in their ratings, and rated themselves to be appropriately negative on the Unpleasant slides, and differences between Schizophrenia and Comparison males in rated emotion were relatively slight. This is consistent with other evidence cited previously that subjective emotional experience is not necessarily lessened in schizophrenia. Second, it appears that Schizophrenia participants were rated by observers to be feeling moderately less appropriate relative to Comparison persons, since they were rated as more negative on the conventionally positive Scenic slides, and less negative on the Unpleasant slides. Thus, emotional experience and expression were significantly different in Schizophrenia and Comparison samples, and these differences may in part account for judgments of inappropriate affect in schizophrenia. Communication Accuracy. However, the differences between Schizophrenia and Comparison samples in rated emotional experience and expression were mild to moderate compared with the large differences in communication accuracy. The large differences demonstrated between male Schizophrenia and Comparison participants in communication accuracy are consistent with the notion that deficits in emotional communication may be at the heart of the effects demonstrated in EE research, and they are not inconsistent with cultural differences in EE patterns demonstrated in recent research. The large differences in communication accuracy are also consistent with a reinterpretation of the double bind hypothesis in terms of emotional as opposed to propositional communication. This allows a new approach integrating EE findings with the DB hypothesis, suggesting that emotional DBs may indeed be specifically schizophrenogenic sources of stress. In traditional British, and more broadly Western, society, the EE qualities of hostility, criticism, and emotional overinvolvement may produce schizophrenogenic emotional DBs; in different cultural contexts, it may be other qualities of emotional expression—yet to be revealed—that may generate emotional DBs, interfere with emotional communication and hence cause schizophrenogenic stress. Fear and surprise. It is noteworthy that the specific emotions communicated most poorly by the Schizophrenia samples—both the males and the few females—were surprise and, particularly, fear. Indeed, fear was not communicated at all. These two emotions were also the most poorly communicated by the 20 schizophrenia patients in the Easton (1995) study: the average emotion correlation for fear was .00 and that for surprise was -.03. The reasons that fear and surprise may be particularly poorly communicated in schizophrenia are not immediately apparent, but this seems to be a consistent finding, and should be investigated in future research. Theoretical Implications. The present findings are consistent with the broader DI theory account of the role of emotional communication in interpersonal communication as bioregulators (Buck, 1989). As relationships become more intimate, there is a change from their being governed by

Authors: Buck, Ross., Sheehan, Megan., Cartwright-Mills, Jacquie., Ray, Ipshita. and Ross, Elliott.
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Page 15
Discussion

Major Findings.
Emotional experience and expression. It appears that Schizophrenia participants
rated themselves as feeling slightly to moderately less appropriately relative to
Comparison persons, as they were relatively more negative on the conventionally positive
Familiar Experimenter slide. However, Schizophrenia participants clearly distinguished
between the slides in their ratings, and rated themselves to be appropriately negative on
the Unpleasant slides, and differences between Schizophrenia and Comparison males in
rated emotion were relatively slight. This is consistent with other evidence cited
previously that subjective emotional experience is not necessarily lessened in
schizophrenia. Second, it appears that Schizophrenia participants were rated by
observers to be feeling moderately less appropriate relative to Comparison persons, since
they were rated as more negative on the conventionally positive Scenic slides, and less
negative on the Unpleasant slides. Thus, emotional experience and expression were
significantly different in Schizophrenia and Comparison samples, and these differences
may in part account for judgments of inappropriate affect in schizophrenia.
Communication
Accuracy. However, the differences between Schizophrenia and
Comparison samples in rated emotional experience and expression were mild to moderate
compared with the large differences in communication accuracy. The large differences
demonstrated between male Schizophrenia and Comparison participants in
communication accuracy are consistent with the notion that deficits in emotional
communication may be at the heart of the effects demonstrated in EE research, and they
are not inconsistent with cultural differences in EE patterns demonstrated in recent
research. The large differences in communication accuracy are also consistent with a
reinterpretation of the double bind hypothesis in terms of emotional as opposed to
propositional communication. This allows a new approach integrating EE findings with
the DB hypothesis, suggesting that emotional DBs may indeed be specifically
schizophrenogenic sources of stress. In traditional British, and more broadly Western,
society, the EE qualities of hostility, criticism, and emotional overinvolvement may
produce schizophrenogenic emotional DBs; in different cultural contexts, it may be other
qualities of emotional expression—yet to be revealed—that may generate emotional DBs,
interfere with emotional communication and hence cause schizophrenogenic stress.
Fear and surprise. It is noteworthy that the specific emotions communicated most
poorly by the Schizophrenia samples—both the males and the few females—were
surprise and, particularly, fear. Indeed, fear was not communicated at all. These two
emotions were also the most poorly communicated by the 20 schizophrenia patients in
the Easton (1995) study: the average emotion correlation for fear was .00 and that for
surprise was -.03. The reasons that fear and surprise may be particularly poorly
communicated in schizophrenia are not immediately apparent, but this seems to be a
consistent finding, and should be investigated in future research.

Theoretical Implications.
The present findings are consistent with the broader DI theory account of the role of
emotional communication in interpersonal communication as bioregulators (Buck, 1989).
As relationships become more intimate, there is a change from their being governed by


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