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Expressed Emotion and the Double-Bind: Communication of Specific Emotions in Schizophrenia
Unformatted Document Text:  Page 7 comparable proportions of females and males. The ratings of all judges viewing a given sender were averaged to provide stable estimates of judgments. At least 11 judges viewed a given sender: this number was found to be adequate to provide stable judgments based upon reliabilities and effect sizes found in previous research: this was determined to be the case for the present study as well. Instruments and Procedures In the initial contact, patients were informed that a study of emotional communication in hospital patients was being conducted, and asked if they would like to learn more about the details of the study. If they initially consented to have the study explained, the consent form was read to them and all tests were explained in advance. The consent form revealed they would be video taped at some point during the experiment but gave no specific details. Schedule. Patients underwent a series of three or four days of testing, which was limited to one hour per day. The typical schedule proceeded as follows: Day 1. The project was explained fully and consent was obtained. Preliminary questions regarding address, phone, age, age of onset of schizophrenia, other medical problems such as alcohol/drug dependence, seizures, depression, stroke, head trauma, handedness, and a brief psychiatric interview were conducted. Then the Mini Mental Status Exam was administered, followed by Digit Span, Mesulam’s Neglect Task and Match/Identify Faces. If the patient was able to quickly complete the above tests, an Attitudinal Vocal Prosody test was administered. If not, it was postponed until the second day of testing. Day 2. On the second day of testing, the Western Aphasia Battery was administered. Day 3. On the third day, the Aprosodia Battery, the Slide Viewing Technique, the Communication of Affect Receiving Ability Test-Form G (CARAT-G) and facial and vocal posing of emotions were administered if the patient had completed the Aprosodia Battery quickly enough. If not, the Slide Viewing Technique and tests following it were deferred until the fourth day. The psychiatric assessment needed to complete the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS: Andreason, 1983; 1984) was accomplished by discussion with professionals, chart review, observation of behavior, and psychiatric interview. The Slide Viewing Technique. The Slide Viewing Technique was administered on the final day of testing. The participant’s photograph had previously been taken using a Minolta 35 mm camera with Polaroid instant color slide film. The picture was taken with an automatic flash at a 10 foot distance against a plain background. The film was developed within five minutes, and the participant's picture was mounted as a slide and placed in the slide projector along with other emotionally-loaded slides to be shown. The participant was seated beside the experimenter four feet in front of a back-lighted slide projection screen mounted on a 9" x 11" x 2 3/4" black plastic box, in which was concealed a 3/4 inch diameter SVHS color video camera. Also in the box was a solid-state timing device which, upon pressing a button, presented a slide, turned on a light to cue the patient to describe his/her feelings ten seconds after the slide appeared, and turned of the light and forwarded the slide to a blank after 20 seconds. Thus, each slide was seen for 20 seconds including an initial ten-second "slide period" and a ten-second "talk period." The participant then rated his or her feelings on a rating form attached to a

Authors: Buck, Ross., Sheehan, Megan., Cartwright-Mills, Jacquie., Ray, Ipshita. and Ross, Elliott.
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comparable proportions of females and males. The ratings of all judges viewing a given
sender were averaged to provide stable estimates of judgments. At least 11 judges
viewed a given sender: this number was found to be adequate to provide stable judgments
based upon reliabilities and effect sizes found in previous research: this was determined
to be the case for the present study as well.

Instruments and Procedures
In the initial contact, patients were informed that a study of emotional communication
in hospital patients was being conducted, and asked if they would like to learn more
about the details of the study. If they initially consented to have the study explained, the
consent form was read to them and all tests were explained in advance. The consent form
revealed they would be video taped at some point during the experiment but gave no
specific details.
Schedule. Patients underwent a series of three or four days of testing, which was
limited to one hour per day. The typical schedule proceeded as follows: Day 1. The
project was explained fully and consent was obtained. Preliminary questions regarding
address, phone, age, age of onset of schizophrenia, other medical problems such as
alcohol/drug dependence, seizures, depression, stroke, head trauma, handedness, and a
brief psychiatric interview were conducted. Then the Mini Mental Status Exam was
administered, followed by Digit Span, Mesulam’s Neglect Task and Match/Identify
Faces. If the patient was able to quickly complete the above tests, an Attitudinal Vocal
Prosody test was administered. If not, it was postponed until the second day of testing.
Day 2. On the second day of testing, the Western Aphasia Battery was administered. Day
3. On the third day, the Aprosodia Battery, the Slide Viewing Technique, the
Communication of Affect Receiving Ability Test-Form G (CARAT-G) and facial and
vocal posing of emotions were administered if the patient had completed the Aprosodia
Battery quickly enough. If not, the Slide Viewing Technique and tests following it were
deferred until the fourth day.
The psychiatric assessment needed to complete the Scale for the Assessment of
Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms
(SANS: Andreason, 1983; 1984) was accomplished by discussion with professionals,
chart review, observation of behavior, and psychiatric interview.
The Slide Viewing Technique. The Slide Viewing Technique was administered on
the final day of testing. The participant’s photograph had previously been taken using a
Minolta 35 mm camera with Polaroid instant color slide film. The picture was taken with
an automatic flash at a 10 foot distance against a plain background. The film was
developed within five minutes, and the participant's picture was mounted as a slide and
placed in the slide projector along with other emotionally-loaded slides to be shown.
The participant was seated beside the experimenter four feet in front of a back-lighted
slide projection screen mounted on a 9" x 11" x 2 3/4" black plastic box, in which was
concealed a 3/4 inch diameter SVHS color video camera. Also in the box was a solid-
state timing device which, upon pressing a button, presented a slide, turned on a light to
cue the patient to describe his/her feelings ten seconds after the slide appeared, and
turned of the light and forwarded the slide to a blank after 20 seconds. Thus, each slide
was seen for 20 seconds including an initial ten-second "slide period" and a ten-second
"talk period." The participant then rated his or her feelings on a rating form attached to a


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