Determinants of low anger control in patients with coronary artery disease

A low anger control has been associated to coronary artery disease (CAD). However, there is scarce information on predictors of low anger control in those patients. All patients scheduled for elective coronary angiography at a tertiary center for cardiology in South Brazil between 11/30/2009 and 02/03/2010 were considered eligible for inclusion. The inclusion criterion was the presence of significant CAD which was defined as the presence of a stenosis >50% in at least one major epicardial artery. Clinical and sociodemographic characteristics of the patients were registered, and anger aspects were assessed by the Spielberger's Anger Expression Inventory. The anger control score was categorized into quartiles, and the lowest quartil was considered and the first quartile (Low Anger Control) was compared with the others (Proper Anger Control). The medians were compared by the POISSON regression with adjustment for single and multiple robust variances. Three hundred and six patients with 60 ± 9 years old with angiographically proven CAD were included in this study. Our results showed that the younger, diabetic and patients with a family history of CAD presented lower medians for the anger control. Body Mass Index was also correlated with anger control. In the multivariate analysis, however, only family history for coronary artery disease was an independent risk factor for a low anger control. These results provide a better understanding of the relationship between anger control and CAD, and should help to consolidate the knowledge in this field and also help to plan further studies to investigate a cause-effect relationship

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Faking a race IRAP effect in the context of single versus multiple label stimuli

In this study, white participants were exposed to a single-label or multiple-label racial bias IRAP before and after a faking instruction (i.e., two exposures to the IRAP). The faking instruction involved asking all participants to imagine that they were a black person when completing the second IRAP. The results indicated that participants produced evidence of pro-white and anti-black biases both before and after receiving the faking instruction. Analyses of variance revealed no main or interaction effects for the single- versus multiple-label variable, and trial-type specific paired t-tests yielded no significant differences between the pre- and post-faking instruction IRAPs. The results were consistent with previous racial bias findings using the IRAP and supported the conclusion that faking only occurs when participants are provided with specific information about the task parameters. Implications for faking research, and the impact of instructions generally, on the IRAP are discussed

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Incidencia de los juegos deportivos de oposición sobre los estados de ánimo en universitarios / Impact of competitive sports games on the mood state of university students / Incidência de jogos de esportes da oposição sobre o estado de humor de estudantes universitários

Este estudio pretende identificar la intensidad de los estados de ánimo durante la práctica de juegos deportivos de oposición y comprobar la relación existente con el historial deportivo de los participantes. Participaron 147 estudiantes universitarios los cuales cumplimentaron el cuestionario POMS (Profile of Mood State). Los resultados indican como las dimensiones tensión y vigor se vivieron con mayor intensidad en los juegos, mientras que depresión y rabia menores. Contar con experiencia deportiva fue determinante. Los jugadores con historial deportivo puntuaron más para la dimensión vigor. Los resultados permiten orientar las intervenciones de futuros profesionales gracias a las experiencias prácticas vivenciadas dentro del ámbito educativo y deportivo

This study intends to identify the intensity of mood states whilst playing competitive sports games and verify the existing relationship with the participants’ sporting record. 147 college students took part in the research, who completed the POMS (Profile of Mood State) questionnaire. Analysis showed that the tension and vigour dimensions were experienced with greater intensity in sports games, while the depression and anger dimensions decreased in intensity. Having experience playing sports was an important factor, showing that players with a record of playing sports scored higher levels in the vigour dimension. The results help to guide interventions by future professionals due to practical experience gained in the field of education and sports

Os objetivos deste estudo são identificar a intensidade de Estados de humor para a prática de jogos de esportes de oposição e verificar arelação existente com rastreamento de esporte dos participantes. Partiparam um total de 147 estudantes universitários que completaram o questionárioPOMS (Perfil do Estado de Humor) adaptado para o espanhol por Balaguer, Fuentes, Meliá e García-Merita (1993). Os resultados indicam que odimensões de vigor e tensão eram experientes com maior intensidade nos jogos de esportes, durante a depressão e raiva dimensões diminuíram deintensidade. A presença de experiência anterior de esportes foi um fator importante, mostrando os jogadores com os jogadores registro de rastreamentoesporte níveis mais elevados para a dimensão de vigor. Resultados ajudam a orientar futuras intervenções por profissionais devido a experiência práticaexperiente no educativo e o campo de esporte

Evidence for cultural dialects in vocal emotion expression: acoustic classification within and across five nations.

The possibility of cultural differences in the fundamental acoustic patterns used to express emotion through the voice is an unanswered question central to the larger debate about the universality versus cultural specificity of emotion. This study used emotionally inflected standard-content speech segments expressing 11 emotions produced by 100 professional actors from 5 English-speaking cultures. Machine learning simulations were employed to classify expressions based on their acoustic features, using conditions where training and testing were conducted on stimuli coming from either the same or different cultures. A wide range of emotions were classified with above-chance accuracy in cross-cultural conditions, suggesting vocal expressions share important characteristics across cultures. However, classification showed an in-group advantage with higher accuracy in within- versus cross-cultural conditions. This finding demonstrates cultural differences in expressive vocal style, and supports the dialect theory of emotions according to which greater recognition of expressions from in-group members results from greater familiarity with culturally specific expressive styles.

Psychometric challenges and proposed solutions when scoring facial emotion expression codes.

Coding of facial emotion expressions is increasingly performed by automated emotion expression scoring software; however, there is limited discussion on how best to score the resulting codes. We present a discussion of facial emotion expression theories and a review of contemporary emotion expression coding methodology. We highlight methodological challenges pertinent to scoring software-coded facial emotion expression codes and present important psychometric research questions centered on comparing competing scoring procedures of these codes. Then, on the basis of a time series data set collected to assess individual differences in facial emotion expression ability, we derive, apply, and evaluate several statistical procedures, including four scoring methods and four data treatments, to score software-coded emotion expression data. These scoring procedures are illustrated to inform analysis decisions pertaining to the scoring and data treatment of other emotion expression questions and under different experimental circumstances. Overall, we found applying loess smoothing and controlling for baseline facial emotion expression and facial plasticity are recommended methods of data treatment. When scoring facial emotion expression ability, maximum score is preferred. Finally, we discuss the scoring methods and data treatments in the larger context of emotion expression research.

Descripción y limitaciones de los instrumentos deevaluación de la emoción expresada / No disponible

La emoción expresada (EE) se refiere a las actitudes afectivas y comportamientos (p. ej., crítica, hostilidad y sobreimplicación emocional)de los familiares hacia un miembro de la familia con trastorno mental. El clima familiar de alta EE constituye un estrés crónicoque contribuye negativamente a la patología del paciente, con lo que la EE se muestra como una variable a tener en cuenta, siendonecesaria su evaluación. El objetivo del presente trabajo es realizar una breve descripción y aproximación a los principales instrumentospara la evaluación del constructo EE, y a sus principales limitaciones. Como conclusiones, destacar que las pruebas tipo entrevistapresentan limitaciones que reducen su aplicabilidad clínica y las pruebas breves, surgidas para evaluar el constructo,requieren de mayor investigación (AU)

Expressed emotion (EE) refers to the affective attitudes and behaviours (i.e., criticism, hostility and emotional over involvement) of relatives toward a family member with a psychiatric illness. The family climate of high EE constitutes a chronic stress and contributes negatively to the patient´s pathology, with what the EE appears as a variable to bearing in mind, being necessary her assessment. The aim of the present work is to realize a brief description and approximation to the principal assessment instruments of the EE construct, and to his principal limitations. As conclusions, to emphasize that interviews present limitations which reduce her clinical applicability and the brief tests, arisen for to assess the construct, need more research (AU)

Procesamiento emocional en personas con sintomatología obsesivo-compulsiva / Emotional processing in people with obsessive-compulsive symptomatology

El presente estudio tuvo como objetivo evaluar la sintomatología obsesivo-compulsiva utilizando la visualización de fotografías afectivas y construidas de acuerdo con el modelo dimensional de las emociones de Peter Lang. Se estudiaron 370 estudiantes de Psicología de la Universidad de Málaga y se seleccionaron los que obtuvieron puntuaciones altas y bajas en sintomatología obsesivo-compulsiva. Todos los participantes evaluaron un conjunto de fotografías de contenido obsesivo-compulsivo mediante las escalas gráficas del Self-Assessment Manikin (SAM) en sus tres dimensiones de valencia afectiva, activación y control/dominancia. Los resultados muestran que las personas altas en sintomatología obsesivo-compulsiva evalúan las imágenes emocionales como elicitadoras de emociones menos controlables. También perciben las imágenes neutras y las de contenido obsesivo-compulsivo como más desagradables (AU)

The present study was aimed at assessing obsessive-compulsive symptomatology based on visualization of affective pictures, elaborated following Peter Lang’s dimensional model of emotion. Participants were 370 psychology students at Malaga University, selecting those with high and low scores in obsessive-compulsive symptomatology. All participants assessed a set of pictures containing obsessive-compulsive cues using the three scales of the Self-Assessment Manikin: affective valence, arousal, and control/dominance. The results show that participants with high scores in obsessive-compulsive symptomatology experience reduced control over the affective pictures and rate as more unpleasant the neutral and obsessivecompulsive pictures (AU)

Clima emocional en equipos de profesionales sanitarios de Andalucía / Emotional climate in health professional teams in Andalusia

Objetivo. El clima emocional en el ámbito de la salud es uno de los factores que afectan directamente el desempeño profesional y la calidad de la atención sanitaria. El objetivo del trabajo es conocer el clima emocional de los equipos de trabajo, en función del número de profesionales que lo componen. Método. Estudio descriptivo, observacional y transversal. Se diseñó un cuestionario de 10 preguntas con escala Likert, para una muestra de 212 profesionales de 17 centros sanitarios. Los resultados se analizaron con el paquete estadístico SPSS, realizando comparación de medias, midiendo la significación estadística con el Test de Anova. Resultados. El clima emocional no describió una tendencia lineal en función del número de profesionales que componían el equipo. Tratando la variable «tamaño del grupo» como cualitativa, se observaron diferencias significativas estadísticamente (en el Test Anova de comparación de media, p<0,01). Los grupos pequeños (<8 personas) tuvieron una valoración general del clima emocional de 18,3 puntos (escala –50, +50). Concretamente, centrándonos en las dimensiones del índice general, el reconocimiento personal se situó en 5,3 puntos (en escala −15,+15), las relaciones interpersonales en 6,0 (escala –15,+15) y la existencia de un proyecto común en 6,9 puntos (escala –20,+20). Los grupos medianos (8–12 personas) tuvieron una valoración mejor (el clima emocional general alcanzó 23,7 puntos y las dimensiones del índice son 7,9; 6,4 y 9,3 respectivamente), mientras que en los grupos grandes (>12 personas) observamos las puntuaciones más altas en todos los aspectos analizados (índice general 26,4 puntos, las dimensiones 9,0; 9,2 y 11,5 respectivamente). Conclusiones. El tamaño del grupo incide en el clima emocional de los equipos de manera directamente proporcional: a mayor tamaño del grupo, mayor calidad del clima emocional(AU)

Objective. The emotional climate in the health care environment is one of the main factors that affect professional duties and quality of care. The aim of this research is to analyse the emotional climate in health work teams, relating it with the number of members in each group. Method. A cross-sectional, descriptive, and observational study with 212 professionals from 17 health centres. They were given a Likert scale questionnaire and the results were analysed using SPSS program, comparing the mean, standard deviation and Anova test. Results. There was no linear relationship between group size and emotional climate. Using “group size” as a qualitative variable, significant results appear: Small groups (<8 persons) scored 18.3 points on the Emotional Climate Scale (−50,+50 scale). Personal recognition received 5.3 points (−15,+15 scale), interpersonal relationships 6.0 points (−15,+15 sclae) and shared projects 6.9 points (−15,+15 scale). Medium groups (8–12 persons) had a better evaluation (23.7 points for the general scale and 7.9, 6.4 and 9.3 for the scale dimensions). Large groups (>12 persons) registered the best results (26.4 points for the general scale and 9.0, 9.2 and 11.5 points for the scale dimensions). Conclusions. Team size directly influences emotional climate: larger groups lead to better emotional climate(AU)

Emoción y memoria de reconocimiento: la discriminación de la información negativa como un proceso adaptativo / Emotion and recognition memory: The discrimination of negative information as an adaptive process

Se estudió el efecto de la emoción generada a través de fotografías del IAPS (International Affective Picture System) sobre el reconocimiento incidental de dichas fotografías con períodos de retención cortos (15 min). Se utilizaron tareas distractoras de memorización y tiempo de reacción, junto a tiempos de exposición breves (2 segundos por fotografía), con el fin de evitar que la elevada tasa de reconocimiento presente en este tipo de trabajos impida comprobar el efecto de la emoción sobre los parámetros de discriminación (A´) y sesgo de respuesta (B´´D) (efecto techo). Para este fin se utilizaron 80 fotografías representativas de los niveles medio y alto del espacio afectivo bidimensional. Los resultados informan de una mayor discriminación y un estilo de respuesta más conservador para las fotografías desagradables y las de arousal medio. Para este tipo de fotografías se obtuvo una mayor confianza y menores tiempos de respuesta en la fase de reconocimiento. Los resultados pueden explicarse por los efectos que el contenido negativo y el nivel de activación de las fotografías tienen sobre el procesamiento atencional y la memoria, e interpretarse como un fenómeno que resulta adaptativo evolutivamente (AU)

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A´) and response bias (B´´D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive (AU)

[Types of anger expression in adolescent women--a Q-Methodological approach].

PURPOSE: The purpose of this study was to identify the types of anger expression in adolescent women. METHODS: The Q-Methodology which provides a method of analyzing the individual's subjectivity was used. The 32 subjects classified 50 selected Q-statements on a 9 point scale to make a normal distribution. The collected data was analyzed by a PCQUANL program. RESULTS: Five types of anger expression in adolescent women were identified. Type I: Direct attacking expression type, Type II: Mature consideration type, Type III: Passive indirect expression type, Type IV: Avoidance conversion type, and Type V: Expression control type. CONCLUSION: This study revealed that different approaches of nursing intervention strategies are recommended based on the five types of anger expression and their characteristics.

Types of Anger Expression in Adolescent Women: A Q-Methodological Approach / 간호학회지

PURPOSE: The purpose of this study was to identify the types of anger expression in adolescent women. METHODS: The Q-Methodology which provides a method of analyzing the individual's subjectivity was used. The 32 subjects classified 50 selected Q-statements on a 9 point scale to make a normal distribution. The collected data was analyzed by a PCQUANL program. RESULTS: Five types of anger expression in adolescent women were identified. Type I: Direct attacking expression type, Type II: Mature consideration type, Type III: Passive indirect expression type, Type IV: Avoidance conversion type, and Type V: Expression control type. CONCLUSION: This study revealed that different approaches of nursing intervention strategies are recommended based on the five types of anger expression and their characteristics.

Assessing expressed emotion: comparing Camberwell Family Interview and Five-minute Speech Sample ratings for mothers of children with behaviour problems.

Little is known of the concordance between ratings of expressed emotion (EE) derived from the Camberwell Family Interview (CFI) and Five-minute Speech Sample (FMSS) for parents of children with behaviour problems. Concordance between CFI and FMSS ratings of EE was assessed prior to intervention and compared to parent-rated behaviour after intervention, at follow-up, 12 months later. Female primary caretakers of 75 children (3-10 years) showing behavioural difficulties were interviewed using FMSS and CFI. Interviews were coded independently by criterion-standard raters. Using CFI, 57 families were classified high EE, and 18 low EE. Using FMSS, 65 families were classified high EE and 10 low EE. 55/75 pairs of ratings (73%) were the same (high, n = 51: low, n = 4) and 20 mothers (27%) were allocated different EE status (Kappa = 0.14, n.s.). The FMSS ratings at initial interview appeared more closely related to behaviour rating at follow-up than CFI. Further investigation is required to establish comparability of CFI and FMSS results for carers of children.

Measuring expressed emotion: an evaluation of the shortcuts.

The construct of expressed emotion (EE) is a highly reliable and valid predictor of poor clinical outcomes in patients with major psychopathology. Patients are at early risk for relapse if they live with family members who are classified as high in EE. Conventionally, EE is assessed with the Camberwell Family Interview (CFI), a semistructured interview that is conducted with the patient's key relatives. Unfortunately, training in the CFI is difficult to obtain. The CFI is also time-consuming to administer and labor intensive to rate. In this article, the authors discuss alternative ways of assessing EE. They also evaluate the predictive validity of these measures and make recommendations for researchers and clinicians interested in using these assessments.

Un estudio comparativo de la inmigración en función del lugar / An immigration comparative study according to origin place: psychosocial variables in Murcia natives

Presentamos un análisis comparativo de los principales grupos de inmigrantes en la Región de Murcia: magrebíes, subsaharianos, europeos del este y latinoamericanos. En este estudio han participado 93 estudiantes de educación secundaria, quienes respondieron a un conjunto de medidas psicosociales, evaluativas, cognitivas y afectivas respecto a cada uno de los grupos de inmigrantes. Las variables incluidas en el estudio han sido: evaluación general, valencia del estereotipo, amplitud del estereotipo, similitud con el endogrupo, emociones positivas, emociones negativas, contacto intergrupal, contribución social positiva y contribución social negativa. Todas las variables, excepto una (las contribuciones sociales positivas), han mostrado diferencias significativas en un análisis de varianza de medidas repetidas en función del origen de los grupos de inmigrantes. Son los inmigrantes magrebíes los que salen más perjudicados en este análisis comparativo

We present a comparative analysis of the main immigrant groups in the Region of Murcia: Magrebians, Sub-Saharans, eastern Europeans and Latin-Americans. 93 secondary school students have taken part in this research. These students answered a set of evaluative, cognitive and affective psychological measurements related to every immigrant group. The variables included in this study are the following: general evaluation, stereotype valency, stereotype extent, ingroup similarity, positive emotions, negative emotions, intergroup contact, positive social contributions and negative social contributions. All variables except for one (the positive social contribution), have displayed significant differences in a repeated measurement Anova, according to the immigrant group origin. Magrebian immigrants are the ones who are more damaged in this comparative analysis

Revelando las emociones: una investigación en curso / Revealing the emotions: a research in progress

Desde la antigüedad filósofos y pensadores se han interesado por las emociones. Su estudio científico está vinculado con los orígenes de la Psicología como disciplina independiente y hoy día estamos viviendo una auténtica revolución emocional en cuanto a su entendimiento. En este trabajo se intentará una aproximación a lo que entendemos por emociones, así como una pequeña revisión del sustrato neurológico que las posibilita y las funciones que cumplen estas complejas reacciones. Las emociones están profundamente imbricadas en nuestra vida mental y cada vez parecen ser más abundantes sus alteraciones. Esto puede deberse a un desfase entre organismo y estructura social (lo que se conoce como retraso en el genoma); no obstante, la mayor parte de estas afecciones podrían paliarse con una adecuada educación emocional que surja desde un paradigma de vida saludable y desarrollo integral del individuo en sociedad, abriéndose las puertas a una nueva Psicología Positiva del siglo XXI, preventiva y centrada en la Salud Pública

Philosophers and thinkers have been keen on emotions since Antiquity. Its scientific study is related to the origins of the Psychology as an independent discipline and nowadays we are living a genuine emotional revolution as for its understanding. In this piece of work we will try an approach to what we consider as emotions and will present a short review of the neurological substratum that makes them possible together with the functions these complex reactions perform. Emotions are deeply overlapped in our mental life and its disturbances seem to be increasing. It can be due to a bad adjustment between organism and social structure (what is known as genoma lag); nevertheless, most of these alterations could be mitigated by a suitable emotional education coming from a paradigm of healthy life and integral growth of the individual in society, the whole opening the door to a new XXIst century Positive Psychology, preventive and focused on Public Health

Family transactions and relapse in bipolar disorder.

This study examined whether patient symptoms and relatives' affective behavior, when expressed during directly observed family interactions, are associated with the short-term course of bipolar disorder. Twenty-seven bipolar patients and their relatives participated in two 10-minute family interactions when patients were discharged after a manic episode. Results indicated that patients who showed high levels of odd and grandiose thinking during the interactions were more likely to relapse during a 9-month followup period than patients who did not show these symptoms during the family discussions. Relapse was also associated with high rates of harshly critical and directly supportive statements by relatives. Patients' odd thinking and relatives' harsh criticism were significantly more likely to be correlated when patients relapsed (r = .53) than when they did not relapse (r = .12). Results suggest that bipolar patients who show increased signs of residual symptomatology during family transactions during the post-hospital period are at increased relapse risk. The data also suggest that relatives of relapsing patients cope with these symptoms by increasing both positive and negative affective behaviors. Moreover, a bidirectional, interactional relationship between patients' symptoms and relatives' coping style seems to capture best the role of the family in predicting relapse in bipolar disorder.

Emoción expresada y características de personalidad, psicopatológicas y de ajuste diádico en padres de esquizofrénicos / Expressed emotion and personality psychopathology and dyaric atjustment in parents of schizophrenics patients

En este estudio hemos relacionado la Emoción Expresada (EE) de los padres con otras variables, para detectar posibles factores asociados a una alta EE, con vistas a planificar intervenciones terapéuticas que incidan en esos factores. Método: hemos estudiado una muestra de 40 familias con un hijo esquizofrénico según criterios diagnósticos del DSM 111-R, en la que hemos evaluado la EE de ambos padres, el Ajuste Diádico (DAS), Personalidad (EPQA), Ansiedad (SAS), Depresión (BDI) y Apoyo y Estrés Social. Resultados: la introversión en las madres se asocia al criticismo (CC) y la extroversión a la sobreimplicación emocional (SIE). La depresión se asocia en los padres a alta SIE y algunas subescalas del DAS están asociadas a CC y SIE. Los familiares críticos tienen menor apoyo social y las madres críticas peor calidad de apoyo. Los familiares bajos en EE tienen más estrés familiar y los padres bajos en SIE más estrés laboral.En conclusión, las intervenciones terapéuticas dirigidas a reducir EE deberían tener en cuenta estas características de los familiares de esquizofrénicos. (AU)

The measurement of expressed emotion in relationships between staff and service users: the use of short speech samples.

OBJECTIVES: Research on expressed emotion (EE) has demonstrated a remarkable consistency across cultures and over time; the psychosocial climate in relationships is important in determining the course of problems in mental health. The rating of EE might be described as the least accessible aspect of this literature to those who have not undertaken a training course. The purpose of this study was twofold: first, to obtain EE ratings for staff-patient relationships via interview and speech sample methods, in order to estimate the validity of the shorter method (the Five-Minute-Speech-Sample, FMSS); second, to examine the generalizability of the FMSS rating method to raters who were not previously trained to rate EE. DESIGN AND METHOD: Staff (N = 15) working in a day hospital service for people with enduring mental health problems were interviewed about their work with at least one patient (N = 32), and also asked to provide an FMSS on each relationship. Ratings of FMSS-EE were subsequently compared with the Camberwell Family Interview-EE ratings. Following an hour-long training period, the FMSS-EE ratings of five postgraduate students were then compared with those of a criterion rater. RESULTS: Correspondence between the two measures of EE was found to be good, with overall agreement achieved in 89.7% of cases. Raters with very limited training in the concept and rating of EE were accurate in identifying the overall rating of the relationship in question, but less accurate in identifying specific critical comments. CONCLUSION: The FMSS technique can be used reliably to identify negative relationships even by raters given very limited training. Clinical and research applications are suggested.

Confirmatory factor analysis of the Level of Expressed Emotion (LEE) scale.

A confirmatory analysis of a previously reported structure for the Level of Expressed Emotion (LEE) scale was conducted with data from 75 volunteers. Three principal components were extracted and rotated to maximum congruence with a target based on previous research. The fit was found to be highly significant and retest correlations for the subscales of the LEE were good. However, the revised LEE scale could probably be improved, especially by the addition of a subscale designed to measure perceived criticism.

Reliability of the 5-min speech sample for assessing expressed emotion in Japanese patients.

Expressed emotion (EE) has been shown in various countries to be a good predictor of the clinical course of a patient's mental illness. Because the traditional EE interview requires considerable time and effort, this study examined the reliability of a method called the five-minute speech sample (FMSS) for assessing EE. The samples of 65 subjects were rated by the FMSS-EE coding system, and the interrater reliability among four authorized raters was investigated. Of these 65 samples, 10 (15%) were rated as high-EE (high critical, 6%; high emotional over-involvement (EOI), 9%), and 19 (29%) were rated as borderline (b-)-high-EE (b-critical, 15%; b-EOI, 14%). The intraclass correlation coefficient (ICC) was 0.91 for the overall category, 0.74 for criticism, 0.85 for EOI, 0.63 for b-critical and 0.54 for b-EOI. The FMSS was shown to be reliable for the assessment of EE, even outside of Western countries. However, the lower agreement in the subcategories of EOI and b-critical has to be considered as a limitation of this brief method.