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Involuntary Emotional Expression Disorder: Definition, Diagnosis, and Measurement Scales

Published online by Cambridge University Press:  07 November 2014

Jeffrey L. Cummings
Jeffrey L. Cummings*
Affiliation:
Dr. Cummings is Augustus S. Rose professor of neurology and professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at the, University of California, Los Angeles (UCLA)
*
University of California Los Angeles, Alzheimer's Disease Center, 10911 Weyburn Avenue, Los Angeles, CA 90095-722. Tel: 310-794-6148; Fax:, 310-206-5287; Email:, jcummings@mednet.ucla.edu
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Abstract

Involuntary emotional expression disorder (IEED) is a syndrome in which emotional or affective motor control becomes dysregulated as a result of brain damage from neurological disease or as a result of brain injury. A debilitating disorder with persistent symptoms, IEED has a significant impact upon the lives of patients and caregivers, but is often overlooked or misdiagnosed. IEED is a clinically well-defined disorder, and specific criteria may be used when making a diagnosis. It must be distinguished from depression or other psychological and neurological conditions. Several assessment scales have been validated for use in IEED, in order to evaluate the baseline severity and to track the course of the disorder and response to treatment.

Type
Research Article
Information
CNS Spectrums , Volume 12 , Issue S5 , 2007 , pp. 11 - 16
Copyright
Copyright © Cambridge University Press 2007

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References

1.Darwin, C. The Expression of the Emotions in Man and Animals. New York & London: D Appleton and Company; 1872.CrossRefGoogle Scholar
2.Arciniegas, DB, Topkoff, J. The neuropsychiatry of pathologic affect: an approach to evaluation and treatment. Semin Clin Neuropsychiatry. 2000;5:290–306.CrossRefGoogle ScholarPubMed
3.Dark, FL, McGrath, JJ, Ron, MA. Pathological laughing and crying. Aust N Z J Psychiatry. 1996;30:472–479.CrossRefGoogle ScholarPubMed
4.Green, RL. Regulation of affect. Semin Clin Neuropsychiatry. 1998;3:195–200.Google ScholarPubMed
5.Schiffer, R, Pope, LE. Review of pseudobulbar affect including a novel and potential therapy. J Neuropsychiatry Clin Neurosci. 2005;17:447–454.CrossRefGoogle ScholarPubMed
6.Cummings, JL, Arciniegas, DB, Brooks, BRet al.Defining and diagnosing involuntary emotional expression disorder. CNS Spectr. 2006;11:1–7.CrossRefGoogle ScholarPubMed
7.Wilson, SAK. Some problems in neurology. No. II. - Pathological laughing and crying. J Neurol Psychopathol. 1924;IV:299–333.CrossRefGoogle Scholar
8. Living with IEED. Available at: http://www.ieed.org. Accessed October 25, 2006.Google Scholar
9. Pseudobulbar affect - disease background. Available at: http://www.pseudobulbar.com. Accessed October 25, 2006.Google Scholar
10.Lieberman, A, Benson, DF. Control of emotional expression in pseudobulbar palsy. A personal experience. Arch Neurol. 1977;34:717–719.CrossRefGoogle ScholarPubMed
11.Zeilig, G, Drubach, DA, Katz-Zeilig, M, Karatinos, J. Pathological laughter and crying in patients with closed traumatic brain injury. Brain Inj. 1996;10:591–597.CrossRefGoogle ScholarPubMed
12.Tsai, WC, Lai, JS, Wang, TG. Treatment of emotionalism with fluoxetine during rehabilitation. Scand J Rehab Med. 1998;30:145–149.Google ScholarPubMed
13.James, W. Principles of Psychology. New York, NY: Dover; 1890.Google Scholar
14.Strub, RL, Black, FW. Neurobehavioural Disorders: A Clinical Approach. Philadelphia, PA: F.A. Davis; 1988.Google Scholar
15.Stuss, DT, Gow, CA, Hetherington, CR. “No longer Gage”: frontal lobe dysfunction and emotional changes. J Consult Clin Psychol. 1992;60:349–359.CrossRefGoogle ScholarPubMed
16.Diagnostic and Statistical Manual of Mental Disorders. 4th ed Text Rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
17.Adams, RD, Victor, M, Ropper, AH. Principles of Neurology. New York: McGraw-Hill; 1997.Google Scholar
18.Arciniegas, DB, Lauterbach, EC, Anderson, KEet al.The differential diagnosis of pseudobulbar affect (PBA). Distinguishing PBA among disorders of mood and affect. Roundtable monograph supplement. CNS Spectr. 2005;10:1–14.Google Scholar
19.Feinstein, A, Feinstein, K, Gray, T, O'Connor, P. Prevalence and neurobehavioral correlates of pathological laughing and crying in multiple sclerosis. Arch Neurol. 1997;54:1116–1121.CrossRefGoogle ScholarPubMed
20.Poeck, K. Pathophysiology of emotional disorders associated with brain damage. In: Disorders of Emotion. 1969:343–367.Google Scholar
21.Kim, JS, Choi, S, Kwon, SU, Seo, YS. Inability to control anger or aggression after stroke. Neurology. 2002;58:1106–1108.CrossRefGoogle ScholarPubMed
22.Langworthy, OR, Hesser, FH. Syndrome of pseudobulbar palsy. Anatomic and physiologic analysis. Arch Intern Med. 1940;65:106–121.CrossRefGoogle Scholar
23.Haupt, M. Emotional lability, intrusiveness, and catastrophic reactions. Int Psychogeriatr. 1996;8(suppl 3):409–414.CrossRefGoogle ScholarPubMed
24.Shaibani, AT, Sabbagh, MN, Doody, R. Laughter and crying in neurologic disorders. Neuropsychiatry Neuropsychol Behav Neurol. 1994;7:243–250.Google Scholar
25.Sackeim, HA, Greenberg, MS, Weiman, AL, Gur, RC, Hungerbuhler, JP, Geschwind, N. Hemispheric asymmetry in the expression of positive and negative emotions. Neurologic evidence. Arch Neurol. 1982;39:210–218.CrossRefGoogle ScholarPubMed
26.Besson, G, Bogousslavsky, J, Regli, F, Maeder, P. Acute pseudobulbar or suprabulbar palsy. Arch Neurol. 1991;48:501–507.CrossRefGoogle ScholarPubMed
27.Paradiso, S, Chemerinski, E, Yazici, KM, Tartaro, A, Robinson, RG. Frontal lobe syndrome reassessed: comparison of patients with lateral or medial frontal brain damage. J Neurol Neurosurg Psychiatry. 1999;67:664–667.CrossRefGoogle ScholarPubMed
28.Lauterbach, EC, Jackson, JG, Price, ST, Wilson, AN, Kirsh, AD, Dever, GE. Clinical, motor and biological correlates of depressive disorders after focal subcortical lesions. J Neuropsychiatry Clin Neurosci. 1997;9:259–266.Google ScholarPubMed
29.Green, RL, McAllister, TW, Bernat, JL. A study of crying in medically and surgically hospitalized patients. Am J Psychiatry. 1987;144:442–447.Google ScholarPubMed
30.Lader, M, Pétursson, H. Psychiatric disorders. In: Girdwood, RH, Petrie, JC, eds. Textbook of Medical Treatment. Edinburgh: Churchill Livingstone; 1987:285–301.Google Scholar
31.Bleuler, EP. Dementia Praecox. New York, NY: International Universities Press; 1950.Google Scholar
32.Paus, S, Urbach, H, Klockgether, T, Hartmann, A. Acute hebephrenia. Arch Neurol. 2005;62:1312–1313.CrossRefGoogle ScholarPubMed
33.Defendorf, AR. Clinical Psychiatry: A Textbook Abstracted and Adapted from the 6th German Edition of Kraepelin's “Lehrbuch der Psychiatrie”. New York, NY: Macmillan Co.; 1904.Google Scholar
34.Berkovic, SF, Andermann, F. Pathological laughing. In: Joseph, AB, Young, RR, eds. Movement Disorders in Neurology and Neuropsychology. Oxford, UK: Blackwell Science; 1999.Google Scholar
35.Duchowny, MS. Pathological disorders of laughter. In: McGhee, PE, Goldstein, JH, eds. Handbook of Human Research. Vol II. New York, NY: Springer-Verlag; 1983.Google Scholar
36.Mendez, MF. Moria and Witzelsücht from frontotemporal dementia. J Neuropsychiatry Clin Neurosci. 2005;17:429–430.CrossRefGoogle ScholarPubMed
37.Sanfilipo, MP, Benedict, RHB, Weinstock-Guttman, B, et al.Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology. 2006;66:685–692.CrossRefGoogle ScholarPubMed
38.Finger, S. A happy state of mind: a history of mild elation, denial of disability, optimism, and laughing in multiple sclerosis. Arch Neurol. 1998;55:241–250.CrossRefGoogle ScholarPubMed
39.Sethi, PK, Rao, TS. Gelastic, quiritarian, and cursive epilepsy. A clinicopathological appraisal. J Neurol Neurosurg Psychiatry. 1976;39:823–828.CrossRefGoogle ScholarPubMed
40.James, W. Subjective effects of nitrous oxide. Mind. 1882;7:186–208.Google Scholar
41.Harris, L, Zucker, R, Lynn, EJ. Some effects of nitrous oxide on fear. J Psychedelic Drugs. 1974;6:29–41.CrossRefGoogle Scholar
42.Steinberg, H. Abnormal behaviour induced by nitrous oxide. Br J Psychol. 1956;47:183–194.CrossRefGoogle ScholarPubMed
43.Raulin, JM. Le Rire et Les Exhilarants. Paris: Baillière; 1900.Google Scholar
44.Siegel, RK, Hirschman, AE. Hashish and laughter: historical notes and translations of early French investigations. J Psychoactive Drugs. 1985;17:87–91.CrossRefGoogle ScholarPubMed
45.Stearns, FR. Laughing. Physiology, Pathophysiology, Psychology, Pathopsychology and Development. Springfield, Ill: Charles C. Thomas; 1972.Google Scholar
46.Stoll, WA. Lysergsäure-diäthylamid, ein Phantastikum aus der Mutterkorngruppe. Schweizer Archiv für Neurologie und Psychiatrie. 1947;60:279–323.Google Scholar
47.Starkstein, SE, Migliorelli, R, Tesón, A, et al.Prevalence and clinical correlates of pathological affective display in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 1995;59:55–60.CrossRefGoogle ScholarPubMed
48.Gopinath, SP. Pathologic laughter in children. Clin Pediatr (Phila). 1993;32:126.CrossRefGoogle ScholarPubMed
49.Jay, V, Becker, LE, Chan, FW, Perry, TL Sr.Puppet-like syndrome of Angelman: a pathologic and neurochemical study. Neurology. 1991;41:416–422.CrossRefGoogle ScholarPubMed
50.Harvey, PD, Greenberg, BR, Serper, MR. The affective lability scales: development, reliability, and validity. J Clin Psychol. 1989;45:786–793.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
51.Sloan, RL, Brown, KW, Pentland, B. Fluoxetine as a treatment for emotional lability after brain injury. Brain Inj. 1992;6:315–319.CrossRefGoogle ScholarPubMed
52.Robinson, RG, Parikh, RM, Lipsey, JR, Starkstein, SE, Price, TR. Pathological laughing and crying following stroke: validation of a measurement scale and a double-blind treatment study. Am J Psychiatry. 1993;150:286–293.Google Scholar
53.Tateno, A, Jorge, RE, Robinson, RG. Pathological laughing and crying following traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2004;16:426–434.CrossRefGoogle ScholarPubMed
54.Newsom-Davis, IC, Abrahams, S, Goldstein, LH, Leigh, PN. The emotional lability questionnaire: a new measure of emotional lability in amyotrophic lateral sclerosis. J Neurol Sci. 1999;169:22–25.CrossRefGoogle ScholarPubMed
55.Moore, SR, Gresham, LS, Bromberg, MB, Kasarkis, EJ, Smith, RA. A self report measure of affective lability. J Neurol Neurosurg Psychiatry. 1997;63:89–93.CrossRefGoogle ScholarPubMed
56.Smith, RA, Berg, JE, Pope, LE, Thisted, RA. Measuring pseudobulbar affect in ALS. Amyotroph Lateral Scler Other Motor Neuron Disord. 2004;5(Suppl 1):99–102.CrossRefGoogle ScholarPubMed