High Expressed Emotion (HEE), Assessed Using the Five-Minute Speech Sample (FMSS), as a Predictor of Psychiatric Relapse in Patients with Schizophrenia and Major Depressive Disorder: A Meta-Analysis and Meta-Regression

Mazza, Cristina; Formica, Federico; Ferracuti, Stefano; Ricci, Eleonora; Colasanti, Marco; Biondi, Silvia; Domenico, Alberto Di; Roma, Paolo

doi:10.3390/jcm11216533

Cited by 5 publications

(3 citation statements)

References 33 publications

(45 reference statements)

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“…Despite being a well-established clinical construct, EE has received very little attention from the affective computing community, whose primary focus is utilising artificial intelligence for the task of emotion recognition [ 9 ]. This is surprising, as the tools and automated methodologies could go some way to relieving the labour and training burden of using humans to code expressed emotion [ 10 ]. Affective computing applications are continually being recognised as being useful in clinical settings; e. g. [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities

Mirheidari,

Bittar,

Cummins

et al. 2024

PLoS ONE

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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.

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Section: Introductionmentioning

confidence: 99%

“…The coding of EE is, however, labour-intensive and requires highly trained raters [ 10 ]. Even after training, human ratings potentially have limited reproducibility as they can be prone to drift and unconscious biases.…”

Section: Introductionmentioning

confidence: 99%

Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities

Mirheidari,

Bittar,

Cummins

et al. 2024

PLoS ONE

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“…It is a robust predictor of patients' illness outcomes in various mental disorders, including schizophrenia, mood disorders, eating disorders, and dementia (6)(7)(8)(9)(10)(11). Over the past decades, meta-analyses and review articles have shed light on its significant impact on mental health disorders (6,10,(12)(13)(14)(15). Despite the substantial empirical research in developed countries and areas, we still need more exploration of expressed emotion from different cultural contexts to expand our understanding of this construct.…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of the Chinese version of the Family Questionnaire among the caregivers of people with schizophrenia

Peng

Xiong

et al. 2023

Front. Public Health

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IntroductionExpressed emotion refers to relatives' attitudes and emotional behaviors toward mentally ill family members. It is a robust predictor of patients' illness outcomes and caregivers' wellbeing in a wide range of mental disorders. However, expressed emotion has not been fully explored in the Chinese context. One reason is the lack of reliable and cost-effective measurements. A reliable, valid, and user-friendly instrument is needed to support the research and clinical practice based on expressed emotion in China. This study aimed to translate, adapt, and examine the psychometric properties (factorial structure, measurement invariance, internal consistency reliability, and concurrent validity) of a Chinese version of the Family Questionnaire.MethodsA total of 248 caregivers participated in the study. A translation and back-translation procedure was applied to translate the Family Questionnaire into Chinese. We compared two models to examine the factor structure of the questionnaire by performing confirmatory factor analysis. We also conducted measurement invariance analysis to test whether the factor structure of the tool is invariant across male and female groups. Reliability was evaluated with Cronbach's α. The concurrent validity was examined by testing the predictivity of the expressed emotion on relevant outcomes with path analysis. We used the STROBE checklist to report.ResultsThe item-total correlation coefficients of the scale ranged from 0.375 to 0.752. The confirmatory factor analysis indicated that the Chinese version of the Family Questionnaire displays the original two-factor structure (emotional overinvolvement and criticism; X2 = 335.50, df = 169, X2/df = 1.985, RMSEA = 0.063, SRMR = 0.058, CFI = 0.913, and TLI = 0.902). In addition, the two-factor structure was invariant across the male and female groups. The two subscales showed excellent internal consistency, with Cronbach's alpha of 0.92 for both emotional overinvolvement and criticism. The concurrent validity of the Chinese version was supported by the good predictivity of the two subscales to care burden, family function, and quality of life. All path coefficients were significant, and the absolute values of path coefficients ranged from 0.23 to 0.72.ConclusionThe Chinese version of the Family Questionnaire is a valid and reliable measurement of expressed emotion in the Chinese context.

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Differential correlates of criticism versus emotional overinvolvement towards patients with schizophrenia living in halfway houses or with their families

Ferentinos,

Douki,

Kourkouni

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose This study systematically searched for differential correlates of criticism vs. emotional overinvolvement (EOI) towards patients with schizophrenia in families and halfway houses, which have only incidentally been reported in previous research. Identified patterns were compared across settings. Methods We included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the expressed emotion (EE) of 22 psychiatric nurses or 56 parents, respectively, through Five Minutes Speech Samples. Each nurse rated 1–12 inpatients and each inpatient was rated by 2–5 nurses. Each outpatient was rated by one or both parents. As EE ratings had a multilevel structure, weighted Spearman correlations of criticism and EOI with various patient- and caregiver-related characteristics were calculated and compared with Meng’s z-test. Results Criticism was weakly negatively correlated with EOI in nurses but negligibly in parents. Distinct patterns of significant differential correlates arose across settings. Outpatients’ aggressive behavior and parents’ related burden were mainly associated with higher criticism. Inpatients’ symptoms (agitation/aggression, negative and other psychotic symptoms) and nurses’ burnout (Depersonalization) were mainly associated with lower EOI. Inpatients’ perceived criticism and outpatients’ previous suicide attempts were equally associated with higher criticism and lower EOI (mirror correlations). Finally, various inpatient attributes (older age, chronicity, unemployment and smoking) triggered higher EOI only. Inpatients’ age, psychopathology (esp. agitation/aggression and negative symptoms) and perceived criticism survived adjustment for multiple comparisons. Conclusion Our findings suggest setting-specific pathogenetic pathways of criticism and EOI and might help customize psychoeducational interventions to staff and families.

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High Expressed Emotion (HEE), Assessed Using the Five-Minute Speech Sample (FMSS), as a Predictor of Psychiatric Relapse in Patients with Schizophrenia and Major Depressive Disorder: A Meta-Analysis and Meta-Regression

Cited by 5 publications

References 33 publications

Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities

Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities

Psychometric properties of the Chinese version of the Family Questionnaire among the caregivers of people with schizophrenia

Differential correlates of criticism versus emotional overinvolvement towards patients with schizophrenia living in halfway houses or with their families

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