Assessment of Emotional Functioning a.

Humans and primates shares similar

emotional state
Definition
Complex psychological event that involve a mixture of Circumplex Model of Affect
reactions: Emotions can be categorized according to two
dimensions: Pleasantness and Arousal
1. A physiological response (arousal
2. An expressive reaction (facial expression) Adaptive Value of Emotional State
3. A Subjective experience (Internal thoughts and 1. Emotions motivate us to perform certain set of
feelings) behaviour
a. Rewards, punishments alters our emotional
Basic Human Emotions (Carroll Ellis)
state allowing for increasing and decreasing
1. Joy
certain behaviour
2. Sadness
2. Give signal to the appropriateness of the behaviour
3. Anger
a. Important in conversation, allow us to
4. Disgust
modify behaviour according to the response
5. Contempt
of the receiver
6. Shame
3. Help to avoid negative situation and taking
7. Fear
advantages of positive situation
8. Guilt
4. Facial expression as predictive signal to
9. Excitement
communicate emotional state
10. Surprise
5. Learned/Innate
7 Elements of Basic Emotional State (Paul a. For survival
Ekman, 1998) b. When we encounter dangerous situations
1. Distinctive Facial Expression (e.g: a snake), there is an instantaneous
a. Each emotion needs distinct facial response to the object
expression Classical Theories of Emotion
b. Facial expression of joy, sadness, guilty is
James-Lange Theory
different.
2. Distinctive Physiological State Cannon-Bard Theory
a. Physiological changes are different for each Schachter-Singer Theory (Two-Factor)
emotions Lazarus’ Appraisal Theory
3. Distinctive Eliciting Stimuli Limbic System in Emotion
a. Things that make you happy should be  Plays a role in how we experience certain types of
different that makes you fear emotions.
b. Triggers are specific to emotions
4. Automatic Appraisal Hypothalamus
a. How you interpret things are automatic and  Regulate autonomic Nervous system (ANS)
according to the emotions  Release hormones that affects arousal
5. Facial expressions and physiological states occur
Thalamus
together
 Sensory Reply Station
6. Instantaneous onset of facial expression and
physiological state Amygdala
a. When you experience the emotion, the  Important in emotions
facial expression and physiological states  Stimulation in this area causes anger, fear and
are triggered instantly. anxiety
7. Share similar expression of emotion state in related  Lesion in Amygdala (bilateral) causes mellowing,
primates. kluver—bucy syndrome (bilateral), Hyperorality (Put
something in mouth), Hypersexuality, Disinhibited
 Behaviour, Benzodiazepine (Similar effects to ***
Alcohol, Benzodiazepine and Alcohol disinhibit the  Many different kinds of emotional alteration take
amygdala). place as a result of TBI
 Severe damage patient =
Hippocampus
 Memory Formation (STM to LTM) Structural Basis of Emotional Changes
 Short term memory is transferred to Long term  Frontal Lobe lesion
memory o Impulsive, labile, acting out, emotionally
flat, disinterested, noninitiating
Symptoms and Signs of Emotional Issues
 Temporal Limbic Lesion
 Diminished emotional control with temper
o Behaviour disturbance is associated with
outbursts, antisocial behaviour
more episodic, with temper outburst or
 Diminished empathy or interest in interpersonal
sudden alterations of mood
relationship without depression
 Affective changes without known precipitative Major Emotional Disturbance
change
Depression and Anxiety
 **
- MDD was more likely to remit than anxiety
 ** - GAD for several weeks + depression can cause
Brain Injury and Emotional Disturbance prolonged depression (Jorge et al., 1993)
 Injuries can lead to issues in experiencing emotions - Anxiety and Depression are frequently reactive
 A lot of patients and caregiver report changes in based on patients appreciation of physical and
emotions after traumatic brain injury in car cognitive limitation
accident. - How they perceive their injuries affects how they
 Some personality or emotional change usually recover from the emotions
follows brain injury - Other related issues such as mania and paranoia are
also reported
 Most common are emotional dulling, disinhibitions,
emotional blandness, mild euphoria ** Personality Disorder
 ** - Increase in rates of personality disorders including
 Profound personality changes frequently follow borderline, avoidant, paranoid, and obsessive-
brain injury compusive have been reported
 Most of the time it is not much of a direct product - Disinhibited or impulsive aggressive with TBI is
of the injury associated with loss of frontal inhibition function.
o But the experience of loss, frustration, life - Verbal Controntation is known to occur more than
style change, that causes diminished physical assault (More verbal assault than physical)
motivations. - Aggressive, childish, impulsive and irritable
behaviour (Greve et al., 2001)
Three types of Emotional Lability
 Emotional ups and down of some labile patients Social Isolation
result from weakened control and lowered - Common consequences of emotional alterations
frustration tolerance. - Reason is because patient becomes boring, difficult,
 Loss of emotional sensitive and the capacity for and unpleasant to be with
modulating emotionally charged behaviour and - Cognitive deficiencies keep the patient from
tend to overreact emotionally. socializing
 Pseudobulbar state, in that their feelings are - This reduces opportunity for establishing new
generally appropriate but there are brief episodes contacts and friends after injury.
of strong affective expression.
o It is result from structural lesions that
Effects of Emotional Issues in TBI
- In some cultures, TBI is viewed as madness and
involve frontal cortex and other brain
some patient feels they bring shame to the family
pathways.
(Simpson et al., 2000)
- Family members are more likely to find physical
deficits acceptable to discuss and deal with than the
emotional personality problem.

Long Term Impairment of TBI

…

1. 40% reported reduced mobility

2. 41% felt tired easily.
3. 36% complain of headaches
4. 26% complains of dizziness
5. 48% complains of visual difficulties

Masson et al. (19966) – Working experience

- Memory problem (67%) – Unable to learn new

things
- Fatigue 58% - Unable to work for long
- Pain 48%
- Dizziness 26%
- Anxiety 63%
- Depressive Temper 41%

Assessment of Emotion
Methods of Assessment
- Clinical Interview
- Psychological Assessment
- Observation
- Others
-