Emotional (Non-)Expression and Health: Data, Questions, and Challenges

Differences of people with visual disabilities in the perceived intensity of emotion inferred from speech of sighted people in online communication settings

PURPOSE

As humans convey information about emotions by speech signals, emotion recognition via auditory information is often employed to assess one's affective states. There are numerous ways of applying the knowledge of emotional vocal expressions to system designs that accommodate users' needs adequately. Yet, little is known about how people with visual disabilities infer emotions from speech stimuli, especially via online platforms (e.g., Zoom). This study focussed on examining the degree to which they perceive emotions strongly or weakly, i.e., perceived intensity but also investigating the degree to which their sociodemographic backgrounds affect them perceiving different intensity levels of emotions when exposed to a set of emotional speech stimuli via Zoom.

MATERIALS AND METHODS

A convenience sample of 30 individuals with visual disabilities participated in zoom interviews. Participants were given a set of emotional speech stimuli and reported the intensity level of the perceived emotions on a rating scale from 1 (weak) to 8 (strong).

RESULTS

When the participants were exposed to the emotional speech stimuli, calm, happy, fearful, sad, and neutral, they reported that neutral was the dominant emotion they perceived with the greatest intensity. Individual differences were also observed in the perceived intensity of emotions, associated with sociodemographic backgrounds, such as health, vision, job, and age.

CONCLUSIONS

The results of this study are anticipated to contribute to the fundamental knowledge that will be helpful for many stakeholders such as voice technology engineers, user experience designers, health professionals, and social workers providing support to people with visual disabilities.IMPLICATIONS FOR REHABILITATIONTechnologies equipped with alternative user interfaces (e.g., Siri, Alexa, and Google Voice Assistant) meeting the needs of people with visual disabilities can promote independent living and quality of life.Such technologies can also be equipped with systems that can recognize emotions via users' voice, such that users can obtain services customized to fit their emotional needs or adequately address their emotional challenges (e.g., early detection of onset, provision of advice, and so on).The results of this study can be beneficial to health professionals (e.g., social workers) who work closely with clients who have visual disabilities (e.g., virtual telehealth sessions) as they could gain insights or learn how to recognize and understand the clients' emotional struggle by hearing their voice, which is contributing to enhancement of emotional intelligence. Thus, they can provide better services to their clients, leading to building a strong bond and trust between health professionals and clients with visual disabilities even they meet virtually (e.g., Zoom).

National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study

Background

Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention.

Methods

We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors.

Results

We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC1 = 5.75, APC2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies.

Conclusions

We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies.

Registration

PROSPERO: CRD42022346558.

Free Your Mind: Emotional Expressive Flexibility Moderates the Effect of Stress on Post-Traumatic Stress Disorder Symptoms

Servicemen are exposed to high levels of stress as part of their daily routine, however, studies which tested the relationship between stress and clinical symptoms reached inconsistent results. The present study examines the role of expressive flexibility, which was determined according to the ability to enhance or suppress either negative or positive emotional expression in conflictual situations, as a possible moderator between stress and Post-Traumatic Stress Disorder (PTSD) symptoms. A total of 82 active-duty firefighters (all men, age range = 25–66, M = 33.59, SD = 9.56, range of years in duty service = 2–41, M = 14.37, SD = 11.79), with different duty-related repeated traumatic exposure, participated in the study. We predicted and found that firefighters with low, but not high, expressive flexibility showed a significant positive correlation between duty-related traumatic exposure and PTSD symptomology (t(81) = 3.85, p < 0.001). Hence, the greater the exposure the higher level of symptoms they exhibited. In addition, we found a difference between the moderating roles of suppressing positive and negative emotional expression, as high but not low, ability to suppress the expression of negative emotions (t(81) = 1.76, p > 0.05), as low but not high, ability to suppress the expression of positive emotions (t(81) = 1.6, p > 0.05), served as a protective factor in buffering the deleterious effect of repeated traumatic exposure. The results provide a pivotal support for the growing body of evidence that a flexible emotional profile is an adaptive one, in dealing with negative life events. However, while there is a need to update behavior, the direction of the adaptive update may differ as a function of valance.

Mindfulness and Quality of Life in Cancer Survivors: The Mediating Role of Self-Kindness and Alexithymia

The purpose of this study was to understand the relationship among mindfulness, self-kindness, alexithymia and quality of life in post-treatment breast cancer survivors and to examine whether self-kindness and alexithymia mediate the relationship between mindfulness and quality of life. Results suggested that the overall model accounted for significant variance in quality of life and that alexithymia partially mediated the relationship between mindfulness and quality of life. Implications for practice and further research are discussed.

Emotions while awaiting lung transplantation: A comprehensive qualitative analysis

Patients awaiting lung transplantation are at risk of negative emotional and physical experiences. How do they talk about emotions? Semi-structured interviews were performed (15 patients). Categorical analysis focusing on emotion-related descriptions was organized into positive–negative–neutral descriptions: for primary and secondary emotions, evaluation processes, coping strategies, personal characteristics, emotion descriptions associated with physical states, (and) contexts were listed. Patients develop different strategies to maintain positive identity and attitude, while preserving significant others from extra emotional load. Results are discussed within various theoretical and research backgrounds, in emphasizing their importance in the definition of emotional support starting from the patient’s perspective.

The Impact of Emotion Regulation and Illness-focused Coping Strategies on the Relation of Illness-related Negative Emotions to Subjective Health

In this study we examined whether emotion regulation and illness-focused coping strategies mediate and/ or moderate the relation of illness-related negative emotions to patients’ subjective health. One hundred and thirty-five cardiac patients participated in the study. Illness-focused coping strategies were found to mediate the relation of emotions to physical functioning, whereas emotion regulation strategies mediated the relation to psychological well-being. Moreover, an emotion regulation strategy (i.e. emotion suppression) and two illness-focused coping strategies (instrumental coping and adherence) moderated the two relationships. These findings suggest that both emotion regulation and illness-focused coping strategies are integral parts of the illness-related negative emotions—health relationship.

Gender Differences in Emotion Regulation and Relationships with Perceived Health in Patients with Rheumatoid Arthritis

Emotion regulation has been associated with perceived health in rheumatoid arthritis, which is diagnosed three times more often in women than men. Our aim was to examine gender differences in styles of emotion regulation (ambiguity, control, orientation, and expression) and gender-specificity of the associations between emotion regulation and perceived health (psychological well-being, social functioning, physical functioning, and disease activity) in 244 female and 91 male patients with rheumatoid arthritis. Women reported more emotional orientation than men, but did not differ from men with regard to ambiguity, control, and expression. Structural equation modelling showed that relationships between emotion regulation and perceived health were more frequent and stronger for women than men. This held especially for the affective dimension of health, while associations were similar for both women and men with regard to social and physical functioning. Only for women, the association between ambiguity and disease activity was significant, which appeared to be mediated by affective functioning. The observations that women are more emotionally oriented than men and that emotion regulation is more interwoven with psychological health in women than men, support the usefulness of a gender-sensitive approach in research and health care of patients with rheumatoid arthritis.

Styles of emotion regulation and their associations with perceived health in patients with rheumatoid arthritis

BACKGROUND

Patients with rheumatoid arthritis face the challenge of adjusting to adverse health consequences and accompanying emotions. Styles of emotion regulation may affect health.

PURPOSE

The objective is to examine associations between styles of emotion regulation and perceived health, consisting of psychological well-being, social functioning, physical functioning, and disease activity.

METHODS

Principal component analysis was used to summarize styles of emotion regulation of 335 patients with rheumatoid arthritis. Relationships between emotion regulation and perceived health were examined with structural equation modeling.

RESULTS

Four styles of emotion regulation were identified: ambiguity, control, orientation, and expression. Ambiguity and control were mutually correlated, as were orientation and expression. Styles of emotion regulation were not uniquely related to perceived physical functioning and disease activity. Emotional ambiguity and orientation were related to poorer, whereas expression and control were related to more favorable psychological well-being and social functioning.

CONCLUSIONS

Our cross-sectional study suggests that emotion regulation is not of direct importance for perceived somatic health of patients with rheumatoid arthritis, but it may be of importance for psychological well-being and social functioning, and perhaps through this route for somatic health. The more conscious and controlled aspects of control and expression are positively related to psychosocial health, and the more unconscious automatic aspects of ambiguity and orientation are negatively related. Changing emotion regulation will potentially affect psychosocial health. It would be worthwhile to verify this possibility in prospective research.