Social Interaction and Symptom Sequences

Emotional cues from expressive behavior of women and men with Parkinson's disease

OBJECTIVE

Emotional experience of people with Parkinson's disease is prone to being misunderstood by observers and even healthcare practitioners, which affects treatment effectiveness and makes clients suffer distress in their social lives. This study was designed to identify reliable emotional cues from expressive behavior in women and men with Parkinson's disease.

METHOD

Videotaped expressive behavior of 96 participants during an interview of discussing enjoyable events was rated using the Interpersonal Communication Rating Protocol. Indices from emotional measures were represented in three components. Correlational analyses between expressive behavior domains and emotional components were conducted for the total sample and by gender separately.

RESULTS

More gross motor expressivity and smiling/laughing indicated more positive affect in the total sample. Less conversational engagement indicated more negative affect in women. However, women with more negative affect and depression appeared to smile and laugh more.

CONCLUSION

This study identified reliable cues from expressive behavior that could be used for assessment of emotional experience in people with Parkinson's disease. For women, because smiling/laughing may convey two possible meanings, that is, more positive and more negative affect, this cue needs to be interpreted cautiously and be used for detecting the intensity, not the type, of emotional experience. Healthcare practitioners should be sensitive to valid cues to make an accurate evaluation of emotion in people with Parkinson's disease.

Expressive behavior in Parkinson's disease as a function of interview context

OBJECTIVE

Parkinson's disease affects the ability to express motivation through face, body, and voice; contextual factors may facilitate or inhibit expressive behavior. The purpose of this study was to determine whether qualities of the interview context are associated with client motivational behavior in Parkinson's disease.

METHOD

Men and women with Parkinson's disease (N = 106) discussed 2 topics (enjoyable activity vs. frustrating activity) during an assessment with a female or male interviewer. From videotaped clips, displays of 4 categories of motivation and 12 verbal and 18 nonverbal, behavioral patterns were rated.

RESULTS

During the discussion of enjoyable activities, participants used more positive words, smiled more, and were more facially expressive. Participants were less talkative about their negative feelings and appeared to be more apathetic with the same-gender interviewer.

CONCLUSION

Occupational therapy practitioners should vary the emotional tone of their questions to improve the validity of motivation assessments.

Multilevel methods for modeling observed sequences of family interaction

Observation of interaction plays a central role in family research. This article discusses how to analyze sequential data generated by discrete microcoding methods to test hypotheses about family interaction. Current methods for studying sequential data are presented, and their limits are discussed. Building on recent applications of contingency table analysis to such data, a multilevel log-linear model is presented that can specify and estimate indicators of individual behavioral tendencies and antecedent-consequent relationships among behaviors, both within and across samples of families. An example of this method is presented using data from a study of couples facing job loss. Potential extensions of this framework for future research are discussed.

Emotional and nonemotional facial expressions in people with Parkinson's disease

We investigated facial expressivity in 19 people with Parkinson's disease (PD; 14 men and 5 women) and 26 healthy controls (13 men and 13 women). Participants engaged in experimental situations that were designed to evoke emotional facial expressions, including watching video clips and holding conversations, and were asked to pose emotions and imitate nonemotional facial movements. Expressivity was measured with subjective rating scales, objective facial measurements (Facial Action Coding System), and self-report questionnaires. As expected, PD participants showed reduced spontaneous facial expressivity across experimental situations. PD participants also had more difficulty than controls posing emotional expressions and imitating nonemotional facial movements. Despite these difficulties, however, PD participants' overall level of expressivity was still tied to emotional experience and social context.

Marital research in the 20th century and a research agenda for the 21st century

In this article we review the advances made in the 20th century in studying marriages. Progress moved from a self-report, personality-based approach to the study of interaction in the 1950s, following the advent of general systems theory. This shift led, beginning in the 1970s, to the rapid development of marital research using a multimethod approach. The development of more sophisticated observational measures in the 1970s followed theorizing about family process that was begun in the decade of the 1950s. New techniques for observation, particularly the study of affect and the merging of synchronized data streams using observational and self-report perceptual data, and the use of sequential and time-series analyses produced new understandings of process and power. Research in the decades of the 1980s and 1990s witnessed the realization of many secular changes in the American family, including the changing role of women, social science's discovery of violence and incest in the family, the beginning of the study of cultural variation in marriages, the expansion of the measurement of marital outcomes to include longevity, health, and physiology (including the immune system), and the study of comorbidities that accompany marital distress. A research agenda for the 21st century is then described.

Symptom study in context: effects of marital quality on signs of Parkinson's disease during patient-spouse interaction

Hypokinesia, the inability to initiate or maintain movement, represents one of the most disabling aspects of Parkinson's disease (PD), and displays intriguing moment-to-moment variability from environmental stressors. Correlates of orofacial hypokinesia (characteristics of spontaneous eye blink and speech) were coded from videotaped interactions for PD patients in maritally distressed and nondistressed dyads. Significant changes occurred only for the patients in distressed relationships on the two strongest neurophysiologic measures of orofacial hypokinesia, rate and duration of spontaneous eye blink. Further analyses suggest two possible explanations for these temporal symptom changes. Distressed spouses may exacerbate symptoms by exposing the patient to negativity. Alternately, nondistressed spouses may compensate for the demands of the interactional task by assuming a greater share of the conversation relative to the patient's contribution. Results are linked to existing literature; the role of social and familial support in chronic illness is discussed.