Emotion psychology can contribute to psychiatric work on affect disorders: A review

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Emotion psychology can contribute to psychiatric work on affect disorders: A review

SCHERER, Klaus R.

Abstract

While psychiatry and psychology can be considered sister disciplines, the all too frequent family feuds have prevented an extensive exchange of theoretical and methodological approaches. This lack of close contact has been to the detriment ofboth disciplines.

Psychiatry, particularly work on the aetiology of mental disease, may profit from psychological theorizing and experimentation on normal functioning. Psychology, on the other hand, can gain important insights from the study of disturbed processes and the availability of natural experiments and controlled intervention programmes. In particular, theoretical, experimental and clinical work on the antecedents, manifestation, and control of emotional states, including their pathological forms, would benefit from closer collaboration between psychiatrists and psychologists

SCHERER, Klaus R. Emotion psychology can contribute to psychiatric work on affect disorders:

A review. Journal of the Royal Society of Medicine, 1989, vol. 82, p. 545-547

Available at:

http://archive-ouverte.unige.ch/unige:101978

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Journal of theRoyal Society of Medicine Volume 82 September 1989 545

Emotion psychology

can

contribute to psychiatric work

on

affect disorders:

a

review

K R Scherer PhD Department of Psychology, University of Geneva, 24rue Gengral-Dufour, CH-1211 Geneva 4, Switzerland

Keywords: affect disorder;depression; digital speech analysis; voice quality; emotion psychology

Whilepsychiatry andpsychologycanbe considered sister disciplines, the all too frequent family feuds haveprevented an extensiveexchange oftheoretical and methodological approaches. This lack of close contacthas been tothe detriment ofbothdisciplines.

Psychiatry, particularly work on the aetiology of mental disease, may profit from psychological theorizingand experimentationonnormalfunctioning.

Psychology, on the otherhand, can gain important insights from the study of disturbed processes and the availability ofnatural experiments andcontrolled interventionprogrammes. Inparticular,theoretical, experimental and clinical work on theantecedents, manifestation, and control of emotional states, including their pathological forms, would benefit from closer collaboration betweenpsychiatristsand psychologists.

Potential contributions from emotion psychology

Twoapproaches to the psychological study of emotion mayprovideimportantleadsforpsychiatricwork on affect disturbance. First,the functionalapproachto conceptualizing emotion, which assumes phylogenetic continuity andwasfirstdescribedby

Darwin',

has gained increasing acceptance in

psychology2-5.

This approachallowsadescriptionofaffect disordersmore closelybasedon anassessment of thefunctionality or dysfunctionality of behaviour. Another angleof interest isthe importantroleof motor expressionas anexternalmanifestation ofinternal affectivearousal.

The notion that emotionalexpressioncan serve as an important sign ofunderlying emotional statesand disorders is the majortenet ofthis paper.

Second,amajoradvance inemotionpsychologyisthe recognitionofthe important rolecognitive information processingplaysastheprecursor of emotionalarousal andasthemajor determinant of thedifferentiation of emotional

states5.

Lazarus and

colleagues6

were amongthe firsttoemphasize therole ofsubjective evaluation ofevents and situations andpropose a 'transaction model' which takes into account the coping potential of the individual. This notion has been of much interesttopsychiatricworkoncoping with lifeevents.Consequently,contrarytothewidely accepted 'generalimpactmodelof

srss',

aspostulated by

Selye7,

recent theorizing argues for the needto distinguish different types of emotional stress as produced by different cognitive evaluationpatterns8.

Aninformationprocessing approach

to affect disorder classification

The remainder of this paper will describe how a combined use of the functional and information

processingapproaches to emotion may contribute to boththeorydevelopmentanddiagnostic procedures for

identifying

affect disorders in psychiatry. It is hypothesized that differentsubjective evaluations of eventsand situations willproduce different emotional states,characterized byhighlydifferentiatedphysio- logical symptoms, feeling patterns, and facial and vocal

epression

patterns.Therefore, faultyevaluations ofevents may lead to emotional disorder and the natureof thisdisorder can bediagnosedonthebasis of vocal and facial expressions. In particular, this paper will concentrate on the vocal channel of expressive communication.

Inproposingacomponent process model of emotion,

Scherer58

haspostulatedasequenceof five 'stimulus evaluation checks' (SECs) as the eliciting and differentiating mechanisms inemotionarousal. An individual is assumed to evaluate situations and events in termsof(1)theirnovelty, (2)their intrinsic pleasantness, (3) their conduciveness to satisfying major needs and goals, (4) the individual's coping potential(control,power,adjustment capacity), and (5) the self and norm compatibility of the event encountered. The emotional stategenerated bythis sequence of SECs will-depend on the pattern of outcomesof the respectivechecks.Forexample,anger will be generated by an event that hinders need satisfaction or goal achievement but which seems surmountablegiventheperceivedcopingpotentialof the individual. In contrast, fear is the responsetoa suddenevent which isalso endangering needs or goals but where thecopingpotentialof theorganism is low or insufficient.

This model allowsustoconceptualizeaffective dis- ordersastheresult of inappropriate affectstatesbeing produced byinappropriatesubjective evaluationsof situations9.Theabnormality or inappropriateness of abehaviouroraffect isdefinedin termsof the social normative judgement concerning these features.

Thus, onewould talk of inappropriate affect in the form ofneuroticanxietyifmostpeople considered the object of fear to be neutral or benevolent rather thanfrightening.Consequently,theabnormal affect has probably been produced by an inappropriate evaluationstrategywhere either the relevance ofan objector eventforsatisfyingone's needsorreaching one's goals has been grossly misjudged, or where the coping potential of the organism has been underestimated.

Atheoretical proposal concerningdifferent typesof affect disorders as consequences of inappropriate evaluation strategies, basedonthe

component

process modeloftheauthor,isshowninTable1.

Nosological

claificationsofaffect disordersinpsychiatry should

Paper read to Section of Psychiatry, 10February 1987

0141-0768/89/

090545-03/$02.00/0

© 1989 TheRoyal Society of Medicine

546 Journal of the Royal Societyof Medicine Volume 82 September 1989 Table 1. Types of affect disorders as a consequence of

inappropriate situationevaluation

Euphoria excessively positive pleasantness and conduciveness evaluation

Anhedonia excessively negative pleasantness evaluation

Chronic dissatis- strong bias towards habitual negative faction, frustration conduciveness evaluation

Indifference, malfimctioningof conduciveness check apathy

Mania overestimation of power and control Hopelessness underestimation of control

Helplessness underestimation of power

Anxiety disorders excessive concern about adequacy of power

Agitated fear underestimation of control and power, overestimationof urgency

bebased on theoriesabout theelicitation of normal emotional states. This approach may provide a theoretical base fordiagnostic criteria. Itmay also help indevisingappropriatetherapeutic strategies, such asattempts to increaseself-esteeminthecase ofan underestimation of personal power or coping potential with everydaylife events.

Digital voice analysis as adiagnostic tool Followingffunctionaltheoriesofemotionandemotional expression, the author has proposed prediction schemes which attempt todescribethenatureof the expressivemanifestationlikelytofollowaparticular SEC result. Forexample, predictionsonhowthree major dimensions of voice quality will change as a result of different SECs were derived from thephysiological, acoustic-phonetic,and phoniatric literature on voice production. Based 0n these assumed phonation and articulation

chaz)ges,

a detailed set of acoustic predictions for different emotions wasproposed10. Using thesameprocedure, predictions on vocalindicatorsofaffectdisorderswere derived(see Table2)9.

Table 2. Voice typepredictions forspecificaffect disorders Pharynx Vocal tract

setting tension Register Euphoria Wide Mediumtense Slightlyfull

Mania Wide Extremely Extremely

tense full

Anhedonia Very Slightlytense Neutral narrow

Helplessness Narrow Lax Thin

Anxiety disorder Narrow Medium to Thin highlytense

Agitated fear Narrow Extremely Very thin tense

Chronic dissatis- Narrow Mediumtense Medium full faction, frustration

Indifference,apathy Neutral Slightly lax Neutral Shame, guilt Narrow -Slightlytense Thin Reproduced from Scherer KR.Vocalassessmentof affective disorders. In: Maser JD, ed. Depression and expression behavior.Hillsdale, NJ:Erlbaum, 1987:77

Acoustic voice parameters are assumed to be direct indicators of a speaker's affect state, and can be obtainedusingmoderndigitalsignal analysis.Progrss in the development of appropriate hardware and software has made itfeasibleto run acompletevoice analysis diagnostic program onespecially equipped personal computers. An advantage of this method of assessing internal state over more traditional methods, such as physiological recording, is that appropriate measures canbeobtainedunobtrusively during anormal interview-

provid&d

the patient talks and thus provides voice samples. Compared to the verbal assessment of emotional state, thismethodhas the advantage of not being sensitive to defensive reactions orother types ofdistortingfactors.

Evidence showing that affect disorders induce vocalchange

Muchofwhat has been outlinedaboVeisstillinthe stage ofhypothetical predictiot. IHowever,

judging

from theavailableexperimentaldata, it appears that voice quality provides an important diagnostic indicatorfor psychiatric work. There is evidencethat emotional statesareindeedreflectedinthevoice and thatnormaljudgescanrecognizethese speakerstates with better thanchance

accuracy10.

Furthermore, a number of studieshave shown that stressproduces reliable changes in vocal parameters, particularly

ndamental frequencyorpitch ofthe

voice8'11.

There are a number ofstudies with psychiatric patients that have attempted to demonstrate the usefulness ofvocal indicators. Inmostof thesestudies, significant changes in voice are associated with changes in affective state9 2-'5. While attempts to

classify

different groups ofpsychiatric patientsonthe basisofvocal indicators remainunsatisfactory, due mostlytotheuseof inappropriatenosological cate- gories, there is evidencethat voice analysiscanbe used to trace changes -in patient affect state over therapy.With bothAmericandepressive and schizo.

phrenic

patients16

and Germandepressive patients (Klos,Ellgring, & Scherer,submitted for publication) anumberof vocalinicators,inpardcularfunental

frequency,

spectral energy distribution, and pause length, changed with patientmoodstateover

different

therapy

periods.

Thereisalsopreliminary evidence thatvocalanalysiscanbe usedas anindicator for.

the effects of psychoactive

drugs'7.

In one study, different antidepressant drugs, as

compared

to a placebo,

significantly

affected

-vocalIfw-damental frequency18.

These

encouraging

results.illustrate thepotential contribution psychology can

make

to.

psychiatryby usinghypothesis-generating theoretical models, and new methodological tools (such as computer-basedanalysesof motor

expression)

forthe study of affect disorder.

Refences

1 Darwin C. Theexpression of theermot in manand animals. London: Murray, 1872

2 To SS. Affecttheory.In:SererKR,Ekman P,eds.

Approaches to emotion.

HIillsadale,

NJ: Eribaum, 1984:

163-94

3 IzardChE. ^Humanemnotions. ^NewYorkr: Plenum, 1977 4 PlutcikR.

Emnotion.

apsychevlutinary synteis.New

Yorl&

Harper & Row, 1980

5 SchererKR.-On the nature and

functiot

of emotion: A component process approach. In:SchererKR,

Ewkman

P, eds.- Approaches to emnotion. Hilladale, NJ: Erlbaum, 1984:293-318

Journal of the Royal Society of Medicine Volume 82 September 1989 547 6 Lazarus RS, Folkman S. Coping and adaption. In:

Gentry WD, ed. The handbook of behavioral medicine.

New York:Guilford, 1984:282-325

7 SelyeH. Theevolutionof the stress concept. American Scientist1973;61:692-9

8 SchererKR. Voice, stress,and emotion. In: Appley MH, Trumbull R, eds. Dynamics ofstress. New York: Plenum, 1986:159-81

9 Scherer KR. Vocal assessmentof affective disorders. In:

Maser JD, ed. Depression and expressive behavior.

Hillsdale, NJ: Erlbaum, 1987:57-83

10 Scherer KR. Vocal affect expression: A review and a model for further research. Psychol Bull1986;99:143-65 11 Scherer KR. Vocal indicators ofstress.1n Darby J,ed Speechevaluation inpsychiatry. eviYrl:Grn*

Stratton, 1981:171-87

12 Darby JK. Speech avA&voice shtdie iat populations. In: Darb ed. eeh evaluation in psychiatry.NewYork:

nr-M- &,atton,41981:253-84

13 BouhuysAL,Muldei valderMeulenWR.

Speech timing measures of s6riy psychomotor

retardation, and agitation in endogenously depressed patients. J Commun Disord 1984;17:277-88

14 Roessler R, Lester JW. Voice predicts affect during psychotherapy. J Nerv Ment Dis 1976;163:166-76 15 Nilsonne A, Sundberg J, Ternstrom S, Askenfelt A.

Measuring the rate ofchange of voice fundamental frequency in fluent speech during mental depression.

J Acoust Soc Am 1988;83:143-64

16 Tolkmitt F,HeifrichH,Standke R, Scherer KR. Vocal indicators of psychiatric treatment effects in depressives andschizophrenics. J Commun Disord1982;15:209-22 17 Feldstein S, Weingaertner H. Speech and psycho- pharmacology. In: Darby JK, ed. Speech evaluation in psychiatry.NewYork: Grune& Stratton,1981:379-96 18

HeIfriq

H, Standke R, Scherer KR. Vocal indicators of

psychoaetive

drug effects. Speech Commun 1984;

3:245-5W

(Accepted1 December1988)

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