Emotionalism following stroke : issues of assessment and correlations with depression and anxiety

Emotionalism is a distressing condition in which voluntary control over emotional expression is lost or reduced. It occurs in 10-20% of patients following stroke and is therefore a significant problem in stroke services. The disorder commonly co-occurs with depression and there is a proposed aetiological relationship between the two conditions. There has been relatively little research on the association between these conditions to date and such investigation is complicated by difficulties in the definition and measurement of emotionalism. The primary aim of the present study was to investigate both the differentiation of emotionalism and depression and the relationship between them. Additional aims were to examine a potential relationship between emotionalism and anxiety and provide information on the psychometric properties of the emotionalism measures used. A cross-sectional questionnaire design was used to assess emotionalism, depression and anxiety in an opportunity sample of 60 participants, in stroke-care services. Analyses were conducted to assess the emotionalism measures and examine the associations between the study variables. The results suggest that the measures of emotionalism and depression did not confound the conditions and were measuring separate constructs. Both depression and anxiety were found to be positively correlated with emotionalism. It was also demonstrated that emotionalism occurred alone and in combination with depression in this sample. The findings support the opinion that psychological variables are important to an understanding of emotionalism, both in relation to its aetiology and for the development of psychological interventions. Clinical implications of the findings and directions for further research are therefore discussed.