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Expressed Emotion and the Double-Bind: Communication of Specific Emotions in Schizophrenia
Unformatted Document Text:  Page 2 Expressed Emotion and the Double-Bind: Experience, Expression, and Communication of Specific Emotions in Schizophrenia and Comparison Samples "Inappropriate affect" has long been cited as characteristic of schizophrenia. There are compelling reasons to believe that schizophrenia is associated with deficits in emotional responding, that such deficits can contribute to disrupted emotional communication, and that such disruption in turn can heighten the severity of schizophrenia symptoms. However, there are no reliable and valid measures of precisely what is "inappropriate" in the emotional experience, expression, and communication patterns of schizophrenia patients. The present study provides a paradigm for assessing such deficits by applying the slide-viewing technique (SVT) used to measure facial/gestural expression and communication in past studies to emotional experience, expression, and communication in schizophrenia. This research aims to develop and validate measures in schizophrenia patients that capture a number of aspects of the emotion process. Specifically, the research measures the self-reported experience of specific emotions, observer ratings of the experience of specific emotions, and spontaneous nonverbal communication of specific emotions in schizophrenia patients and comparison persons. The long-term goal of the research is to assess whether enhanced emotional communication can ameliorate schizophrenia symptoms, leading to less need for drugs and lower recidivism. Emotional Communication as a Bioregulator Social support and health. There is much evidence that social support can contribute significantly to physical health, in animals as well as human beings (Bovard, 1959). The Developmental-Interactionist theory of emotion interprets these effects as acting through emotional communication (Buck, 1989, 1993, Buck & VanLear, 2002). Specifically, it is suggested that the development of a personal relationship intrinsically involves unique patterns of nonverbal/emotional communication such that the ability of the partners to “read” each other increases, and the partner becomes a more reliable source of social biofeedback. The more intimate the relationship, the deeper, more intense, and more unique the pattern of emotional communication, so the relationship is characterized by increased reciprocal empathy, or rapport. Furthermore, it is suggested that this pattern of deep and unique emotional communication serves bioregulatory functions, which can enhance physical health by buffering stress and enhancing immune system functioning. These bioregulatory effects are often revealed when the relationship ends, as when bereavement commonly has devastating effects on physical health. Emotional communication and schizophrenia. There also is evidence that schizophrenia is commonly associated with deficits of emotional expression and communication that could potentially interfere with the establishment of intimate personal relationships; and furthermore that disrupted personal relationships are associated with the intensification of schizophrenia symptoms. As noted, although “inappropriate affect” has long been recognized as a cardinal symptom of schizophrenia, the term is poorly defined, and there are no reliable and valid measures of exactly what aspects of affect or emotion are “inappropriate.” Expressed emotion and schizophrenia. High levels of expressed emotion (EE) within the family, including hostility, criticism, and "emotional overinvolvement," have been

Authors: Buck, Ross., Sheehan, Megan., Cartwright-Mills, Jacquie., Ray, Ipshita. and Ross, Elliott.
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Page 2
Expressed Emotion and the Double-Bind:
Experience, Expression, and Communication of Specific Emotions
in Schizophrenia and Comparison Samples

"Inappropriate affect" has long been cited as characteristic of schizophrenia. There are
compelling reasons to believe that schizophrenia is associated with deficits in emotional
responding, that such deficits can contribute to disrupted emotional communication, and
that such disruption in turn can heighten the severity of schizophrenia symptoms.
However, there are no reliable and valid measures of precisely what is "inappropriate" in
the emotional experience, expression, and communication patterns of schizophrenia
patients. The present study provides a paradigm for assessing such deficits by applying
the slide-viewing technique (SVT) used to measure facial/gestural expression and
communication in past studies to emotional experience, expression, and communication
in schizophrenia. This research aims to develop and validate measures in schizophrenia
patients that capture a number of aspects of the emotion process. Specifically, the
research measures the self-reported experience of specific emotions, observer ratings of
the experience of specific emotions, and spontaneous nonverbal communication of
specific emotions in schizophrenia patients and comparison persons. The long-term goal
of the research is to assess whether enhanced emotional communication can ameliorate
schizophrenia symptoms, leading to less need for drugs and lower recidivism.

Emotional Communication as a Bioregulator
Social support and health. There is much evidence that social support can contribute
significantly to physical health, in animals as well as human beings (Bovard, 1959). The
Developmental-Interactionist theory of emotion interprets these effects as acting through
emotional communication (Buck, 1989, 1993, Buck & VanLear, 2002). Specifically, it is
suggested that the development of a personal relationship intrinsically involves unique
patterns of nonverbal/emotional communication such that the ability of the partners to
“read” each other increases, and the partner becomes a more reliable source of social
biofeedback. The more intimate the relationship, the deeper, more intense, and more
unique the pattern of emotional communication, so the relationship is characterized by
increased reciprocal empathy, or rapport. Furthermore, it is suggested that this pattern of
deep and unique emotional communication serves bioregulatory functions, which can
enhance physical health by buffering stress and enhancing immune system functioning.
These bioregulatory effects are often revealed when the relationship ends, as when
bereavement commonly has devastating effects on physical health.
Emotional communication and schizophrenia. There also is evidence that
schizophrenia is commonly associated with deficits of emotional expression and
communication that could potentially interfere with the establishment of intimate
personal relationships; and furthermore that disrupted personal relationships are
associated with the intensification of schizophrenia symptoms. As noted, although
“inappropriate affect” has long been recognized as a cardinal symptom of schizophrenia,
the term is poorly defined, and there are no reliable and valid measures of exactly what
aspects of affect or emotion are “inappropriate.”
Expressed emotion and schizophrenia. High levels of expressed emotion (EE) within
the family, including hostility, criticism, and "emotional overinvolvement," have been


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