Developmental Contributions to Emotional Awareness

Assessing Criterion A of the Alternative Model for Personality Disorders: The Potential of Performance-Based Personality Measures

The conceptualization of personality disorder has been refined through recent nosological advances introduced in the Alternative Model for Personality Disorders (AMPD). These advances locate self and interpersonal (dys)function at the core of personality pathology. Self-report personality assessment instruments have demonstrated promise in the assessment of Criterion A domains. However, research highlighting the utility of performance-based personality assessment instruments has been largely absent in these advances, despite acknowledgment of their potential. We adhered to PRISMA review guidelines to survey and assess the potential relevance and utility of select performance-based personality instruments in assessing Criterion A domains of the AMPD. We conclude that performance-based personality measures are uniquely positioned to assess maladaptive self- and interpersonal functioning and may address some limitations of self-report measures. Toward this end, we propose a working model that provides ranges of test scores that correspond to the 5-point scale of the Criterion A domains of the AMPD.

Impaired emotional awareness is associated with childhood maltreatment exposure and positive symptoms in schizophrenia

Objectives

Evidence suggests that emotional awareness-the ability to identify and label emotions-may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms.

Methods

The current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ).

Results

Patients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect.

Conclusion

These data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.

Compassion-A key to innovation: What promotes and what prevents innovation in organizations?

Innovation is crucial for the survival and wellbeing of organizations in volatile, rapidly changing societies. However, the role of profound human capability, compassion, and innovation has not been adequately investigated. This article sets out to explore the factors preventing and promoting innovation in organizations, asking how compassion is connected to these factors, and how compassion could boost innovation. We approach innovation as a complicated multilevel phenomenon, emerging from interactions between individuals and the work context. Our view of compassion includes both compassion and copassion-responding both to the suffering and joy of others. Our material was collected from nine focus group interviews, organized in Finland in 2017, in private, public, and third-sector organizations. The material was analyzed by two researchers, using an adapted grounded theory methodology. We found four core factors capable of either promoting or preventing innovation: (1) the strategy and structures of the organization, (2) resources, especially time, (3) working culture; and (4) the dynamics of interaction between individuals and the community. Our key conclusion, fruitful to theorizing both innovation and compassion, is that for innovation to flourish, compassion is to be cultivated throughout an organization. It is not a single variable or practice, and it is in many ways in a key position regarding innovation: the existence of it promotes innovation, but the lack of it prevents innovation. Thus, organizations aiming for innovation should seek multifaceted understanding and skills in compassion.

Psychopathic tendencies are selectively associated with reduced emotional awareness in the context of early adversity

It is unclear at present whether psychopathic tendencies are associated with lower or higher levels of emotional awareness (EA). Given that psychopathy includes a proficiency for manipulating others, one might expect an elevated ability to identify and use information about others' emotions. On the other hand, empathic deficits in psychopathy could arise from reduced emotional awareness. Further, heterogeneity in psychopathy may also play a role, wherein 'secondary' psychopathy is associated with early adversity and high negative affect, while 'primary' psychopathy is not. In this paper, we tested the relationship between EA and psychopathic tendencies in 177 undergraduate students (40 males) who completed the levels of emotional awareness scale (LEAS), the triarchic psychopathy measure (TPM), the affective (empathy-related) subscales of the interpersonal reactivity index (IRI), and two measures of early adversity: the childhood experiences of care and abuse questionnaire (CECA) and the childhood trauma questionnaire (CTQ). We found that lower LEAS scores were associated with higher TPM and lower IRI empathy scores, but these relationships were primarily present in those with early adversity and high negative affect. This suggests that lower EA may be selectively associated with higher levels of secondary psychopathy, while those with higher levels of primary psychopathy remain capable of higher EA.

Higher emotional awareness is associated with greater domain-general reflective tendencies

The tendency to reflect on the emotions of self and others is a key aspect of emotional awareness (EA)—a trait widely recognized as relevant to mental health. However, the degree to which EA draws on general reflective cognition vs. specialized socio-emotional mechanisms remains unclear. Based on a synthesis of work in neuroscience and psychology, we recently proposed that EA is best understood as a learned application of domain-general cognitive processes to socio-emotional information. In this paper, we report a study in which we tested this hypothesis in 448 (125 male) individuals who completed measures of EA and both general reflective cognition and socio-emotional performance. As predicted, we observed a significant relationship between EA measures and both general reflectiveness and socio-emotional measures, with the strongest contribution from measures of the general tendency to engage in effortful, reflective cognition. This is consistent with the hypothesis that EA corresponds to the application of general reflective cognitive processes to socio-emotional signals.

Levels of Emotional Awareness: Theory and Measurement of a Socio-Emotional Skill

Emotional awareness is the ability to conceptualize and describe one's own emotions and those of others. Over thirty years ago, a cognitive-developmental theory of emotional awareness patterned after Piaget's theory of cognitive development was created as well as a performance measure of this ability called the Levels of Emotional Awareness Scale (LEAS). Since then, a large number of studies have been completed in healthy volunteers and clinical populations including those with mental health or systemic medical disorders. Along the way, there have also been further refinements and adaptations of the LEAS such as the creation of a digital version in addition to further advances in the theory itself. This review aims to provide a comprehensive summary of the evolving theoretical background, measurement methods, and empirical findings with the LEAS. The LEAS is a reliable and valid measure of emotional awareness. Evidence suggests that emotional awareness facilitates better emotion self-regulation, better ability to navigate complex social situations and enjoy relationships, and better physical and mental health. This is a relatively new but promising area of research in the domain of socio-emotional skills. The paper concludes with some recommendations for future research.

Emotional Awareness in Schizophrenia Is Associated With Gray Matter Volume of Right Precuneus

Objectives: We assessed the relationship between emotional awareness (e.g., the ability to identify and differentiate our own feelings and feelings of others) and regional brain volumes in healthy and in schizophrenia groups. Methods: Magnetic resonance images of 29 subjects with schizophrenia and 33 matched healthy controls were acquired. Brain gray matter was parcellated using FreeSurfer and 28 regions of interest associated with emotional awareness were analyzed. All participants were assessed using the Levels of Emotional Awareness Scale (LEAS) of Self and of Other. LEAS scores were correlated with gray matter volume for each hemisphere on the 14 brain regions of the emotional awareness network. Results: Individuals with schizophrenia showed decreased emotional awareness on both LEAS Self and LEAS Other compared to healthy controls. There were no statistically significant between-group differences in gray matter volumes of the emotional awareness network. The performance on LEAS Other correlated negatively with right precuneus gray matter volume only in the schizophrenia group. Conclusion: Our findings suggest a relationship between gray matter volume of the right precuneus and deficits in understanding of emotional states of others in schizophrenia.

Affective agnosia: a core affective processing deficit in the alexithymia spectrum

Affective agnosia, an impairment in knowing how one feels emotionally, has been described as an extreme deficit in the experience and expression of emotion that may confer heightened risk for adverse medical outcomes. Alexithymia, by contrast, has been proposed as an over-arching construct that includes a spectrum of deficits of varying severity, including affective agnosia at the more severe end. This perspective has been challenged by Taylor and colleagues, who argue that the concept of affective agnosia is unnecessary. We compare these two perspectives by highlighting areas of agreement, reasons for asserting the importance of the affective agnosia concept, errors in Taylor and colleagues’ critique, and measurement issues. The need for performance-based measures of the ability to mentally represent emotional states in addition to metacognitive measures is emphasized. We then draw on a previously proposed three-process model of emotional awareness that distinguishes affective response generation, conceptualization and cognitive control processes which interact to produce a variety of emotional awareness and alexithymia phenotypes - including affective agnosia. The tools for measuring these three processes, their neural substrates, the mechanisms of brain-body interactions that confer heightened risk for adverse medical outcomes, and the differential treatment implications for different kinds of deficits are described. By conceptualizing alexithymia as a spectrum of deficits, the opportunity to match specific deficit mechanisms with personalized treatment for patients will be enhanced.

Simulating Emotions: An Active Inference Model of Emotional State Inference and Emotion Concept Learning

The ability to conceptualize and understand one's own affective states and responses - or "Emotional awareness" (EA) - is reduced in multiple psychiatric populations; it is also positively correlated with a range of adaptive cognitive and emotional traits. While a growing body of work has investigated the neurocognitive basis of EA, the neurocomputational processes underlying this ability have received limited attention. Here, we present a formal Active Inference (AI) model of emotion conceptualization that can simulate the neurocomputational (Bayesian) processes associated with learning about emotion concepts and inferring the emotions one is feeling in a given moment. We validate the model and inherent constructs by showing (i) it can successfully acquire a repertoire of emotion concepts in its "childhood", as well as (ii) acquire new emotion concepts in synthetic "adulthood," and (iii) that these learning processes depend on early experiences, environmental stability, and habitual patterns of selective attention. These results offer a proof of principle that cognitive-emotional processes can be modeled formally, and highlight the potential for both theoretical and empirical extensions of this line of research on emotion and emotional disorders.

The Relationship Between Trait Emotional Intelligence, Cognition, and Emotional Awareness: An Interpretative Model

Emotional awareness (EA) has been defined as the cognitive skill devoted to the identification and description of one’s own and others’ emotional experiences, an ability that has usually been conceptualized along with the development of cognitive intelligence. Despite this, EA has also been deemed a central constituent of Emotional Intelligence (EI), a construct that captures individual differences in how we perceive, communicate, regulate, and understand our own emotions, as well as the emotions of others. The overlap between the cognitive and the emotional domain in the definition of the EA construct has created several difficulties in both its understanding and its usage, so much so that several questions regarding its nature and structure remain unanswered. The aim of the present work was to test in a unique model the explanatory role of both trait EI and fluid nonverbal intelligence on EA variability in children, controlling for the effect of age, a variable strictly related to cognitive development, as well as gender, which is highly associated with trait EI during childhood. Four hundred and eighty-eight pupils (258 females and 230 males) ranging from 8 to 12 years old completed the Levels of Emotional Awareness Scale for Children, the Trait Emotional Intelligence Questionnaire – Child Form, and a measure of pure non-verbal reasoning ability, the Raven’s Progressive Matrices. The results of a structural equation model showed a positive explanatory power of both Raven and TEIQue scores on EA, revealing that both cognitive intelligence and trait EI significantly explained EA. The same model also showed an indirect effect of age, via intelligence scores, on EA, suggesting that the increase of EA with age could be partially imputed to the development of intelligence. Finally, a relation between gender and TEIQue scores confirmed higher trait EI scores in girls than in boys. The implications emerging from this model are discussed.

Higher levels of trait emotional awareness are associated with more efficient global information integration throughout the brain: a graph-theoretic analysis of resting state functional connectivity

Previous studies have suggested that trait differences in emotional awareness (tEA) are clinically relevant, and associated with differences in neural structure/function. While multiple leading theories suggest that conscious awareness requires widespread information integration across the brain, no study has yet tested the hypothesis that higher tEA corresponds to more efficient brain-wide information exchange. Twenty-six healthy volunteers (13 females) underwent a resting state functional magnetic resonance imaging scan, and completed the Levels of Emotional Awareness Scale (LEAS; a measure of tEA) and the Wechsler Abbreviated Scale of Intelligence (WASI-II; a measure of general intelligence quotient [IQ]). Using a whole-brain (functionally defined) region of interest (ROI) atlas, we computed several graph theory metrics to assess the efficiency of brain-wide information exchange. After statistically controlling for differences in age, gender and IQ, we first observed a significant relationship between higher LEAS scores and greater average degree (i.e. overall whole-brain network density). When controlling for average degree, we found that higher LEAS scores were also associated with shorter average path lengths across the collective network of all included ROIs. These results jointly suggest that individuals with higher tEA display more efficient global information exchange throughout the brain. This is consistent with the idea that conscious awareness requires global accessibility of represented information.