Anxiety

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Anxiety 

Anxiety is an emotion characterized by an unpleasant state of inner turmoil, often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination. It includes subjectively unpleasant feelings of dread over anticipated events.

Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing. It is often accompanied by muscular tension, restlessness, fatigue and problems in concentration. Anxiety is closely related to fear, which is a response to a real or perceived immediate threat; anxiety involves the expectation of future threat. People facing anxiety may withdraw from situations which have provoked anxiety in the past.

Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persisting beyond developmentally appropriate periods. They differ from transient fear or anxiety, often stress-induced, by being persistent (e.g., typically lasting 6 months or more), although the criterion for duration is intended as a general guide with allowance for some degree of flexibility and is sometimes of shorter duration in children.

Anxiety vs. fear

A job applicant with a worried facial expression

Anxiety is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat. Anxiety is related to the specific behaviors of fight-or-flight responses, defensive behavior or escape. It occurs in situations only perceived as uncontrollable or unavoidable, but not realistically so. David Barlow defines anxiety as "a future-oriented mood state in which one is not ready or prepared to attempt to cope with upcoming negative events," and that it is a distinction between future and present dangers which divides anxiety and fear. Another description of anxiety is agony, dread, terror, or even apprehension. In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.

Fear and anxiety can be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear is short-lived, present-focused, geared towards a specific threat, and facilitating escape from threat; anxiety, on the other hand, is long-acting, future-focused, broadly focused towards a diffuse threat, and promoting excessive caution while approaching a potential threat and interferes with constructive coping.

Joseph E. LeDoux and Lisa Feldman Barrett have both sought to separate automatic threat responses from additional associated cognitive activity within anxiety.

Symptoms

Anxiety can be experienced with long, drawn-out daily symptoms that reduce quality of life, known as chronic (or generalized) anxiety, or it can be experienced in short spurts with sporadic, stressful panic attacks, known as acute anxiety. Symptoms of anxiety can range in number, intensity, and frequency, depending on the person. While almost everyone has experienced anxiety at some point in their lives, most do not develop long-term problems with anxiety.

Anxiety may cause psychiatric and physiological symptoms.

The risk of anxiety leading to depression could possibly even lead to an individual harming themselves, which is why there are many 24-hour suicide prevention hotlines.

The behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety or negative feelings in the past. Other effects may include changes in sleeping patterns, changes in habits, increase or decrease in food intake, and increased motor tension (such as foot tapping).

The emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank" as well as "nightmares/bad dreams, obsessions about sensations, déjà vu, a trapped-in-your-mind feeling, and feeling like everything is scary." It may include a vague experience and feeling of helplessness.

The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can't get it out of your mind."

The physiological symptoms of anxiety may include:

• Neurological, as headache, paresthesias, fasciculations, vertigo, or presyncope.
• Digestive, as abdominal pain, nausea, diarrhea, indigestion, dry mouth, or bolus.
• Respiratory, as shortness of breath or sighing breathing.
• Cardiac, as palpitations, tachycardia, or chest pain.
• Muscular, as fatigue, tremors, or tetany.
• Cutaneous, as perspiration, or itchy skin.
• Uro-genital, as frequent urination, urinary urgency, dyspareunia, or impotence, chronic pelvic pain syndrome. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate IBS.

Types

Painting entitled Anxiety, 1894, by Edvard Munch

There are various types of anxiety. Existential anxiety can occur when a person faces angst, an existential crisis, or nihilistic feelings. People can also face mathematical anxiety, somatic anxiety, stage fright, or test anxiety. Social anxiety refers to a fear of rejection and negative evaluation by other people.

Existential

The philosopher Søren Kierkegaard, in The Concept of Anxiety (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In Art and Artist (1932), the psychologist Otto Rank wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.

The theologian Paul Tillich characterized existential anxiety as "the state in which a being is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the human condition or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by tradition and authority" even though such "undoubted certitude is not built on the rock of reality".

According to Viktor Frankl, the author of Man's Search for Meaning, when a person is faced with extreme mortal dangers, the most basic of all human wishes is to find a meaning of life to combat the "trauma of nonbeing" as death is near.

Depending on the source of the threat, psychoanalytic theory distinguishes the following types of anxiety:

• realistic
• neurotic
• moral

Test and performance

According to Yerkes-Dodson law, an optimal level of arousal is necessary to best complete a task such as an exam, performance, or competitive event. However, when the anxiety or level of arousal exceeds that optimum, the result is a decline in performance.

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students who have test anxiety may experience any of the following: the association of grades with personal worth; fear of embarrassment by a teacher; fear of alienation from parents or friends; time pressures; or feeling a loss of control. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, uncontrollable crying or laughing and drumming on a desk are all common. Because test anxiety hinges on fear of negative evaluation, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia. The DSM-IV classifies test anxiety as a type of social phobia.

While the term "test anxiety" refers specifically to students, many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult. Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.

Stranger, social, and intergroup anxiety

Humans generally require social acceptance and thus sometimes dread the disapproval of others. Apprehension of being judged by others may cause anxiety in social environments.

Anxiety during social interactions, particularly between strangers, is common among young people. It may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. According to Cutting, social phobics do not fear the crowd but the fact that they may be judged negatively.

Social anxiety varies in degree and severity. For some people, it is characterized by experiencing discomfort or awkwardness during physical social contact (e.g. embracing, shaking hands, etc.), while in other cases it can lead to a fear of interacting with unfamiliar people altogether. Those suffering from this condition may restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social anxiety also forms a core aspect of certain personality disorders, including avoidant personality disorder.

To the extent that a person is fearful of social encounters with unfamiliar others, some people may experience anxiety particularly during interactions with outgroup members, or people who share different group memberships (i.e., by race, ethnicity, class, gender, etc.). Depending on the nature of the antecedent relations, cognitions, and situational factors, intergroup contact may be stressful and lead to feelings of anxiety. This apprehension or fear of contact with outgroup members is often called interracial or intergroup anxiety.

As is the case with the more generalized forms of social anxiety, intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory. Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction. Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility. Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.

Trait

Anxiety can be either a short-term 'state' or a long-term personality "trait". Trait anxiety reflects a stable tendency across the lifespan of responding with acute, state anxiety in the anticipation of threatening situations (whether they are actually deemed threatening or not). A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders. Such anxiety may be conscious or unconscious.

Personality can also be a trait leading to anxiety and depression. Through experience, many find it difficult to collect themselves due to their own personal nature.

Choice or decision

Anxiety induced by the need to choose between similar options is increasingly being recognized as a problem for individuals and for organizations. In 2004, Capgemini wrote: "Today we're all faced with greater choice, more competition and less time to consider our options or seek out the right advice."

In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making. There are primarily two forms of this anxiety type. The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.

Panic disorder

Panic disorder may share symptoms of stress and anxiety, but it is actually very different. Panic disorder is an anxiety disorder that occurs without any triggers. According to the U.S Department of Health and Human Services, this disorder can be distinguished by unexpected and repeated episodes of intense fear. Someone who suffers from panic disorder will eventually develop constant fear of another attack and as this progresses it will begin to affect daily functioning and an individual's general quality of life. It is reported by the Cleveland Clinic that panic disorder affects 2 to 3 percent of adult Americans and can begin around the time of the teenage and early adult years. Some symptoms include: difficulty breathing, chest pain, dizziness, trembling or shaking, feeling faint, nausea, fear that you are losing control or are about to die. Even though they suffer from these symptoms during an attack, the main symptom is the persistent fear of having future panic attacks.

Anxiety disorders

Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses. Anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism. The disorder differs by what results in the symptoms. People often have more than one anxiety disorder.

Anxiety disorders are caused by a complex combination of genetic and environmental factors. To be diagnosed, symptoms typically need to be present for at least six months, be more than would be expected for the situation, and decrease a person's ability to function in their daily lives. Other problems that may result in similar symptoms include hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.

Without treatment, anxiety disorders tend to remain. Treatment may include lifestyle changes, counselling, and medications. Counselling is typically with a type of cognitive behavioural therapy.^[55] Medications, such as antidepressants or beta blockers, may improve symptoms.

About 12% of people are affected by an anxiety disorder in a given year and between 5–30% are affected at some point in their life. They occur about twice as often in women than they do in men, and generally begin before the age of 25. The most common are specific phobia which affects nearly 12% and social anxiety disorder which affects 10% at some point in their life. They affect those between the ages of 15 and 35 the most and become less common after the age of 55. Rates appear to be higher in the United States and Europe.

Short- and long-term anxiety

Anxiety can be either a short-term "state" or a long-term "trait". Whereas trait anxiety represents worrying about future events, anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear.

Co-morbidity

Anxiety disorders often occur with other mental health disorders, particularly major depressive disorder, bipolar disorder, eating disorders, or certain personality disorders. It also commonly occurs with personality traits such as neuroticism. This observed co-occurrence is partly due to genetic and environmental influences shared between these traits and anxiety.

Anxiety is often experienced by those with obsessive–compulsive disorder and is an acute presence in panic disorder.

Risk factors

A marble bust of the Roman Emperor Decius from the Capitoline Museum. This portrait "conveys an impression of anxiety and weariness, as of a man shouldering heavy [state] responsibilities".

Anxiety disorders are partly genetic, with twin studies suggesting 30-40% genetic influence on individual differences in anxiety. Environmental factors are also important. Twin studies show that individual-specific environments have a large influence on anxiety, whereas shared environmental influences (environments that affect twins in the same way) operate during childhood but decline through adolescence. Specific measured ‘environments’ that have been associated with anxiety include child abuse, family history of mental health disorders, and poverty. Anxiety is also associated with drug use, including alcohol, caffeine, and benzodiazepines (which are often prescribed to treat anxiety).

Neuroanatomy

Neural circuitry involving the amygdala (which regulates emotions like anxiety and fear, stimulating the HPA Axis and sympathetic nervous system) and hippocampus (which is implicated in emotional memory along with the amygdala) is thought to underlie anxiety. People who have anxiety tend to show high activity in response to emotional stimuli in the amygdala. Some writers believe that excessive anxiety can lead to an overpotentiation of the limbic system (which includes the amygdala and nucleus accumbens), giving increased future anxiety, but this does not appear to have been proven.

Research upon adolescents who as infants had been highly apprehensive, vigilant, and fearful finds that their nucleus accumbens is more sensitive than that in other people when deciding to make an action that determined whether they received a reward. This suggests a link between circuits responsible for fear and also reward in anxious people. As researchers note, "a sense of 'responsibility', or self-agency, in a context of uncertainty (probabilistic outcomes) drives the neural system underlying appetitive motivation (i.e., nucleus accumbens) more strongly in temperamentally inhibited than noninhibited adolescents".

The gut-brain axis

The microbes of the gut can connect with the brain to affect anxiety. There are various pathways along which this communication can take place. One is through the major neurotransmitters. The gut microbes such as Bifidobacterium and Bacillus produce the neurotransmitters GABA and dopamine, respectively. The neurotransmitters signal to the nervous system of the gastrointestinal tract, and those signals will be carried to the brain through the vagus nerve or the spinal system. This is demonstrated by the fact that altering the microbiome has shown anxiety- and depression-reducing effects in mice, but not in subjects without vagus nerves.

Another key pathway is the HPA axis, as mentioned above. The microbes can control the levels of cytokines in the body, and altering cytokine levels creates direct effects on areas of the brain such as the hypothalmus, the area that triggers HPA axis activity. The HPA axis regulates production of cortisol, a hormone that takes part in the body's stress response. When HPA activity spikes, cortisol levels increase, processing and reducing anxiety in stressful situations. These pathways, as well as the specific effects of individual taxa of microbes, are not yet completely clear, but the communication between the gut microbiome and the brain is undeniable, as is the ability of these pathways to alter anxiety levels.

With this communication comes the potential to treat anxiety. Prebiotics and probiotics have been shown to reduced anxiety. For example, experiments in which mice were given fructo- and galacto-oligosaccharide prebiotics and Lactobacillus probiotics have both demonstrated a capability to reduce anxiety. In humans, results are not as concrete, but promising.

Genetics

Genetics and family history (e.g. parental anxiety) may put an individual at increased risk of an anxiety disorder, but generally external stimuli will trigger its onset or exacerbation. Estimates of genetic influence on anxiety, based on studies of twins, range from 25–40% depending on the specific type and age-group under study. For example, genetic differences account for about 43% of variance in panic disorder and 28% in generalized anxiety disorder. Longitudinal twin studies have shown the moderate stability of anxiety from childhood through to adulthood is mainly influenced by stability in genetic influence. When investigating how anxiety is passed on from parents to children, it is important to account for sharing of genes as well as environments, for example using the intergenerational children-of-twins design.

Many studies in the past used a candidate gene approach to test whether single genes were associated with anxiety. These investigations were based on hypotheses about how certain known genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) that are implicated in anxiety. None of these findings are well replicated, with the possible exception of TMEM132D, COMT and MAO-A. The epigenetic signature of BDNF, a gene that codes for a protein called brain derived neurotrophic factor that is found in the brain, has also been associated with anxiety and specific patterns of neural activity. and a receptor gene for BDNF called NTRK2 was associated with anxiety in a large genome-wide investigation. The reason that most candidate gene findings have not replicated is that anxiety is a complex trait that is influenced by many genomic variants, each of which has a small effect on its own. Increasingly, studies of anxiety are using a hypothesis-free approach to look for parts of the genome that are implicated in anxiety using big enough samples to find associations with variants that have small effects. The largest explorations of the common genetic architecture of anxiety have been facilitated by the UK Biobank, the ANGST consortium and the CRC Fear, Anxiety and Anxiety Disorders.

Medical conditions

Many medical conditions can cause anxiety. This includes conditions that affect the ability to breathe, like COPD and asthma, and the difficulty in breathing that often occurs near death. Conditions that cause abdominal pain or chest pain can cause anxiety and may in some cases be a somatization of anxiety; the same is true for some sexual dysfunctions. Conditions that affect the face or the skin can cause social anxiety especially among adolescents, and developmental disabilities often lead to social anxiety for children as well. Life-threatening conditions like cancer also cause anxiety.

Furthermore, certain organic diseases may present with anxiety or symptoms that mimic anxiety. These disorders include certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, folic acid), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease), heart diseases, blood diseases (anemia), cerebral vascular accidents (transient ischemic attack, stroke), and brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease), among others.

Substance-induced

Several drugs can cause or worsen anxiety, whether in intoxication, withdrawal or as side effect. These include alcohol, tobacco, cannabis, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs like heroin), stimulants (such as caffeine, cocaine and amphetamines), hallucinogens, and inhalants. While many often report self-medicating anxiety with these substances, improvements in anxiety from drugs are usually short-lived (with worsening of anxiety in the long term, sometimes with acute anxiety as soon as the drug effects wear off) and tend to be exaggerated. Acute exposure to toxic levels of benzene may cause euphoria, anxiety, and irritability lasting up to 2 weeks after the exposure.

Psychological

Poor coping skills (e.g., rigidity/inflexible problem solving, denial, avoidance, impulsivity, extreme self-expectation, negative thoughts, affective instability, and inability to focus on problems) are associated with anxiety. Anxiety is also linked and perpetuated by the person's own pessimistic outcome expectancy and how they cope with feedback negativity. Temperament (e.g., neuroticism) and attitudes (e.g. pessimism) have been found to be risk factors for anxiety.

Cognitive distortions such as overgeneralizing, catastrophizing, mind reading, emotional reasoning, binocular trick, and mental filter can result in anxiety. For example, an overgeneralized belief that something bad "always" happens may lead someone to have excessive fears of even minimally risky situations and to avoid benign social situations due to anticipatory anxiety of embarrassment. In addition, those who have high anxiety can also create future stressful life events. Together, these findings suggest that anxious thoughts can lead to anticipatory anxiety as well as stressful events, which in turn cause more anxiety. Such unhealthy thoughts can be targets for successful treatment with cognitive therapy.

Psychodynamic theory posits that anxiety is often the result of opposing unconscious wishes or fears that manifest via maladaptive defense mechanisms (such as suppression, repression, anticipation, regression, somatization, passive aggression, dissociation) that develop to adapt to problems with early objects (e.g., caregivers) and empathic failures in childhood. For example, persistent parental discouragement of anger may result in repression/suppression of angry feelings which manifests as gastrointestinal distress (somatization) when provoked by another while the anger remains unconscious and outside the individual's awareness. Such conflicts can be targets for successful treatment with psychodynamic therapy. While psychodynamic therapy tends to explore the underlying roots of anxiety, cognitive behavioral therapy has also been shown to be a successful treatment for anxiety by altering irrational thoughts and unwanted behaviors.

Evolutionary psychology

An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but an individual suffering from anxiety may also avoid real threats. This may explain why anxious people are less likely to die due to accidents. There is ample empirical evidence that anxiety can have adaptive value. Within a school, timid fish are more likely than bold fish to survive a predator. 

When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased blood flow in the amygdala. In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.

Social

Social risk factors for anxiety include a history of trauma (e.g., physical, sexual or emotional abuse or assault), bullying, early life experiences and parenting factors (e.g., rejection, lack of warmth, high hostility, harsh discipline, high parental negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, discouragement of emotions, poor socialization, poor attachment, and child abuse and neglect), cultural factors (e.g., stoic families/cultures, persecuted minorities including the disabled), and socioeconomics (e.g., uneducated, unemployed, impoverished although developed countries have higher rates of anxiety disorders than developing countries). A 2019 comprehensive systematic review of over 50 studies showed that food insecurity in the United States is strongly associated with depression, anxiety, and sleep disorders. Food-insecure individuals had an almost 3 fold risk increase of testing positive for anxiety when compared to food-secure individuals.

Gender socialization

Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, self-efficacy, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.

Treatment

The first step in the management of a person with anxiety symptoms involves evaluating the possible presence of an underlying medical cause, whose recognition is essential in order to decide the correct treatment. Anxiety symptoms may mask an organic disease, or appear associated with or as a result of a medical disorder.

Cognitive behavioral therapy (CBT) is effective for anxiety disorders and is a first line treatment. CBT appears to be equally effective when carried out via the internet. While evidence for mental health apps is promising, it is preliminary.

Psychopharmacological treatment can be used in parallel to CBT or can be used alone. As a general rule, most anxiety disorders respond well to first-line agents. First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for routine use. Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and sertraline, among others.

Prevention

The above risk factors give natural avenues for prevention. A 2017 review found that psychological or educational interventions have a small yet statistically significant benefit for the prevention of anxiety in varied population types.

Pathophysiology

Anxiety disorder appears to be a genetically inherited neurochemical dysfunction that may involve autonomic imbalance; decreased GABA-ergic tone; allelic polymorphism of the catechol-O-methyltransferase (COMT) gene; increased adenosine receptor function; increased cortisol.

In the central nervous system (CNS), the major mediators of the symptoms of anxiety disorders appear to be norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotropin-releasing factor, may be involved. Peripherally, the autonomic nervous system, especially the sympathetic nervous system, mediates many of the symptoms. Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.

The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Anxiety processing in the basolateral amygdala has been implicated with dendritic arborization of the amygdaloid neurons. SK2 potassium channels mediate inhibitory influence on action potentials and reduce arborization.

Emotional intelligence

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Emotional_intelligence 

Emotional intelligence (EI), emotional quotient (EQ) and emotional intelligence quotient (EIQ), is the capability of individuals to recognize their own emotions and those of others, discern between different feelings and label them appropriately, use emotional information to guide thinking and behavior, and adjust emotions to adapt to environments. Although the term first appeared in 1964, it gained popularity in the 1995 best-selling book Emotional Intelligence, written by science journalist Daniel Goleman. Goleman defined EI as the array of skills and characteristics that drive leadership performance.

Various models have been developed to measure EI. The trait model, developed by Konstantinos V. Petrides in 2001, focuses on self reporting of behavioral dispositions and perceived abilities. The ability model, developed by Peter Salovey and John Mayer in 2004, focuses on the individual's ability to process emotional information and use it to navigate the social environment. Goleman's original model may now be considered a mixed model that combines what has since been modeled separately as ability EI and trait EI. More recent research has focused on emotion recognition, which refers to the attribution of emotional states based on observations of visual and auditory nonverbal cues. In addition, neurological studies have sought to characterize the neural mechanisms of emotional intelligence.

Studies have shown that people with high EI have greater mental health, job performance, and leadership skills, although no causal relationships have been shown. EI is typically associated with empathy because it involves an individual connecting their personal experiences with those of others. Since its popularization in recent decades, methods of developing EI have become widely sought by individuals seeking to become more effective leaders.

Criticisms have centered on whether EI is a real intelligence, and whether it has incremental validity over IQ and the Big Five personality traits. However, meta-analyses have found that EI has substantial validity even when controlling for IQ and personality.

History

The term "emotional intelligence" seems first to have appeared in a 1964 paper by Michael Beldoch, and in the 1966 paper by B. Leuner entitled Emotional intelligence and emancipation which appeared in the psychotherapeutic journal: Practice of child psychology and child psychiatry.

In 1983, Howard Gardner's Frames of Mind: The Theory of Multiple Intelligences introduced the idea that traditional types of intelligence, such as IQ, fail to fully explain cognitive ability. He introduced the idea of multiple intelligences which included both interpersonal intelligence (the capacity to understand the intentions, motivations and desires of other people) and intrapersonal intelligence (the capacity to understand oneself, to appreciate one's feelings, fears and motivations).

The first published use of the term 'EQ' (Emotional Quotient) is an article by Keith Beasley in 1987 in the British Mensa magazine.

Late in 1998, a Harvard Business Review article entitled "What Makes a Leader," caught the attention of senior management at Johnson & Johnson's Consumer Companies (JJCC). The article spoke to the importance of Emotional Intelligence (EI) in leadership success, and cited several studies that demonstrated that EI is often the distinguishing factor between great leaders and average leaders. JJCC funded a study which concluded that there was a strong relationship between superior performing leaders and emotional competence, supporting theorist's suggestions that the social, emotional and relational competency set commonly referred to as Emotional Intelligence, is a distinguishing factor in leadership performance.

In 1989 Stanley Greenspan put forward a model to describe EI, followed by another by Peter Salovey and John Mayer published in the following year.

However, the term became widely known with the publication of Goleman's book: Emotional Intelligence – Why it can matter more than IQ (1995). It is to this book's best-selling status that the term can attribute its popularity. Goleman has followed up with several similar publications that reinforce use of the term.

Tests measuring EI have not replaced IQ tests as a standard metric of intelligence. Emotional Intelligence has also received criticism on its role in leadership and business success.

Definitions

Emotional intelligence has been defined, by Peter Salovey and John Mayer, as "the ability to monitor one's own and other people's emotions, to discriminate between different emotions and label them appropriately, and to use emotional information to guide thinking and behavior". This definition was later broken down and refined into four proposed abilities: perceiving, using, understanding, and managing emotions. These abilities are distinct yet related. Emotional intelligence also reflects abilities to join intelligence, empathy and emotions to enhance thought and understanding of interpersonal dynamics. However, substantial disagreement exists regarding the definition of EI, with respect to both terminology and operationalizations. Currently, there are three main models of EI:

1. Ability model
2. Mixed model (usually subsumed under trait EI)
3. Trait model

Different models of EI have led to the development of various instruments for the assessment of the construct. While some of these measures may overlap, most researchers agree that they tap different constructs.

Specific ability models address the ways in which emotions facilitate thought and understanding. For example, emotions may interact with thinking and allow people to be better decision makers (Lyubomirsky et al. 2005). A person who is more responsive emotionally to crucial issues will attend to the more crucial aspects of his or her life. Aspects of emotional facilitation factor is to also know how to include or exclude emotions from thought depending on context and situation. This is also related to emotional reasoning and understanding in response to the people, environment and circumstances one encounters in his or her day-to-day life.

Ability model

Salovey and Mayer's conception of EI strives to define EI within the confines of the standard criteria for a new intelligence. Following their continuing research, their initial definition of EI was revised to "The ability to perceive emotion, integrate emotion to facilitate thought, understand emotions and to regulate emotions to promote personal growth." However, after pursuing further research, their definition of EI evolved into "the capacity to reason about emotions, and of emotions, to enhance thinking. It includes the abilities to accurately perceive emotions, to access and generate emotions so as to assist thought, to understand emotions and emotional knowledge, and to reflectively regulate emotions so as to promote emotional and intellectual growth." 

The ability-based model views emotions as useful sources of information that help one to make sense of and navigate the social environment. The model proposes that individuals vary in their ability to process information of an emotional nature and in their ability to relate emotional processing to a wider cognition. This ability is seen to manifest itself in certain adaptive behaviors. The model claims that EI includes four types of abilities:

1. Perceiving emotions – the ability to detect and decipher emotions in faces, pictures, voices, and cultural artifacts—including the ability to identify one's own emotions. Perceiving emotions represents a basic aspect of emotional intelligence, as it makes all other processing of emotional information possible.
2. Using emotions – the ability to harness emotions to facilitate various cognitive activities, such as thinking and problem-solving. The emotionally intelligent person can capitalize fully upon his or her changing moods in order to best fit the task at hand.
3. Understanding emotions – the ability to comprehend emotion language and to appreciate complicated relationships among emotions. For example, understanding emotions encompasses the ability to be sensitive to slight variations between emotions, and the ability to recognize and describe how emotions evolve over time.
4. Managing emotions – the ability to regulate emotions in both ourselves and in others. Therefore, the emotionally intelligent person can harness emotions, even negative ones, and manage them to achieve intended goals.

The ability EI model has been criticized in the research for lacking face and predictive validity in the workplace. However, in terms of construct validity, ability EI tests have great advantage over self-report scales of EI because they compare individual maximal performance to standard performance scales and do not rely on individuals' endorsement of descriptive statements about themselves.

Measurement

The current measure of Mayer and Salovey's model of EI, the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) is based on a series of emotion-based problem-solving items. Consistent with the model's claim of EI as a type of intelligence, the test is modeled on ability-based IQ tests. By testing a person's abilities on each of the four branches of emotional intelligence, it generates scores for each of the branches as well as a total score.

Central to the four-branch model is the idea that EI requires attunement to social norms. Therefore, the MSCEIT is scored in a consensus fashion, with higher scores indicating higher overlap between an individual's answers and those provided by a worldwide sample of respondents. The MSCEIT can also be expert-scored so that the amount of overlap is calculated between an individual's answers and those provided by a group of 21 emotion researchers.

Although promoted as an ability test, the MSCEIT is unlike standard IQ tests in that its items do not have objectively correct responses. Among other challenges, the consensus scoring criterion means that it is impossible to create items (questions) that only a minority of respondents can solve, because, by definition, responses are deemed emotionally "intelligent" only if the majority of the sample has endorsed them. This and other similar problems have led some cognitive ability experts to question the definition of EI as a genuine intelligence.

In a study by Føllesdal, the MSCEIT test results of 111 business leaders were compared with how their employees described their leader. It was found that there were no correlations between a leader's test results and how he or she was rated by the employees, with regard to empathy, ability to motivate, and leader effectiveness. Føllesdal also criticized the Canadian company Multi-Health Systems, which administers the MSCEIT test. The test contains 141 questions but it was found after publishing the test that 19 of these did not give the expected answers. This has led Multi-Health Systems to remove answers to these 19 questions before scoring but without stating this officially.

Other measurements

Various other specific measures have also been used to assess ability in emotional intelligence. These measures include:

1. Diagnostic Analysis of Non-verbal Accuracy – The Adult Facial version includes 24 photographs of equal amount of happy, sad, angry, and fearful facial expressions of both high and low intensities which are balanced by gender. The tasks of the participants is to answer which of the four emotions is present in the given stimuli.
2. Japanese and Caucasian Brief Affect Recognition test – Participants try to identify 56 faces of Caucasian and Japanese individuals expressing seven emotions such happiness, contempt, disgust, sadness, anger, surprise, and fear, which may also trail off for 0.2 seconds to a different emotion.
3. Levels of Emotional Awareness Scale – Participants reads 26 social scenes and answers their anticipated feelings and continuum of low to high emotional awareness.

Mixed model

The model introduced by Daniel Goleman focuses on EI as a wide array of competencies and skills that drive leadership performance. Goleman's model outlines five main EI constructs (for more details see "What Makes A Leader" by Daniel Goleman, best of Harvard Business Review 1998):

1. Self-awareness – the ability to know one's emotions, strengths, weaknesses, drives, values and goals and recognize their impact on others while using gut feelings to guide decisions.
2. Self-regulation – involves controlling or redirecting one's disruptive emotions and impulses and adapting to changing circumstances.
3. Social skill – managing relationships to get along with others
4. Empathy – considering other people's feelings especially when making decisions
5. Motivation – being aware of what motivates them.

Goleman includes a set of emotional competencies within each construct of EI. Emotional competencies are not innate talents, but rather learned capabilities that must be worked on and can be developed to achieve outstanding performance. Goleman posits that individuals are born with a general emotional intelligence that determines their potential for learning emotional competencies. Goleman's model of EI has been criticized in the research literature as mere "pop psychology".

Measurement

Two measurement tools are based on the Goleman model:

1. The Emotional Competence Inventory (ECI), which was created in 1999, and the Emotional and Social Competence Inventory (ESCI), a newer edition of the ECI was developed in 2007. The Emotional and Social Competence – University Edition (ESCI-U) is also available. These tools developed by Goleman and Boyatzis provide a behavioral measure of the Emotional and Social Competencies.
2. The Emotional Intelligence Appraisal, which was created in 2001 and which can be taken as a self-report or 360-degree assessment.

Trait model

Konstantinos V. Petrides ("K. V. Petrides") proposed a conceptual distinction between the ability based model and a trait based model of EI and has been developing the latter over many years in numerous publications. Trait EI is "a constellation of emotional self-perceptions located at the lower levels of personality." In lay terms, trait EI refers to an individual's self-perceptions of their emotional abilities. This definition of EI encompasses behavioral dispositions and self-perceived abilities and is measured by self report, as opposed to the ability based model which refers to actual abilities, which have proven highly resistant to scientific measurement. Trait EI should be investigated within a personality framework. An alternative label for the same construct is trait emotional self-efficacy.

The trait EI model is general and subsumes the Goleman model discussed above. The conceptualization of EI as a personality trait leads to a construct that lies outside the taxonomy of human cognitive ability. This is an important distinction in as much as it bears directly on the operationalization of the construct and the theories and hypotheses that are formulated about it.

Measurement

There are many self-report measures of EI, including the EQ-i, the Swinburne University Emotional Intelligence Test (SUEIT), and the Schutte EI model. None of these assess intelligence, abilities, or skills (as their authors often claim), but rather, they are limited measures of trait emotional intelligence. The most widely used and widely researched measure of self-report or self-schema (as it is currently referred to) emotional intelligence is the EQ-i 2.0. Originally known as the BarOn EQ-i, it was the first self-report measure of emotional intelligence available, the only measure predating Goleman's best-selling book. There are over 200 studies that have used the EQ-i or EQ-i 2.0. It has the best norms, reliability, and validity of any self-report instrument and was the first one reviewed in the Buros Mental Measures Book. The EQ-i 2.0 is available in many different languages as it is used worldwide.

The TEIQue provides an operationalization for the model of Konstantinos V. Petrides and colleagues, that conceptualizes EI in terms of personality. The test encompasses 15 subscales organized under four factors: well-being, self-control, emotionality, and sociability. The psychometric properties of the TEIQue were investigated in a study on a French-speaking population, where it was reported that TEIQue scores were globally normally distributed and reliable.

The researchers also found TEIQue scores were unrelated to nonverbal reasoning (Raven's matrices), which they interpreted as support for the personality trait view of EI (as opposed to a form of intelligence). As expected, TEIQue scores were positively related to some of the Big Five personality traits (extraversion, agreeableness, openness, conscientiousness) as well as inversely related to others (alexithymia, neuroticism). A number of quantitative genetic studies have been carried out within the trait EI model, which have revealed significant genetic effects and heritabilities for all trait EI scores. Two recent studies (one a meta-analysis) involving direct comparisons of multiple EI tests yielded very favorable results for the TEIQue.

The Big Five Personality Traits theory gives a simple blueprint to understand others and improving relationships by knowing why people tend to behave the way they do. You can also use this theory to help better understand yourself and how to get along with others better than ever before. The Big Five Model, is also known as the Five Factor Model, is the most widely accepted personality theory held by psychologist today. The theory states that personality personality can boil down to five factors, known as the acronym CANOE or OCEAN (conscientiousness, agreeableness, neuroticism, extraversion). Unlike other trait theories that sort individuals into binary categories (introvert or extrovert), the Big Five Model asserts that each personality trait is a spectrum. Therefore, individuals are ranked on a scale between two extreme ends.

General effects

A review published in the journal of Annual Psychology found that higher emotional intelligence is positively correlated with:

1. Better social relations for children – Among children and teens, emotional intelligence positively correlates with good social interactions, relationships and negatively correlates with deviance from social norms, anti-social behavior measured both in and out of school as reported by children themselves, their own family members as well as their teachers.
2. Better social relations for adults – High emotional intelligence among adults is correlated with better self-perception of social ability and more successful interpersonal relationships while less interpersonal aggression and problems.
3. Highly emotionally intelligent individuals are perceived more positively by others – Other individuals perceive those with high EI to be more pleasant, socially skilled and empathic to be around.
4. Better academic achievement – Emotional intelligence is correlated with greater achievement in academics as reported by teachers but generally not higher grades once the factor of IQ is taken into account.
5. Better social dynamics at work as well as better negotiating ability.
6. Better psychological well-being - Emotional intelligence is positively correlated with higher life satisfaction, self-esteem and lower levels of insecurity or depression. It is also negatively correlated with poor health choices and behavior.

Emotionally intelligent individuals are more likely to have a better understanding of themselves and to make conscious decisions based on emotion and rationale combined. Overall, it leads a person to self-actualization.

Criticisms

EI, and Goleman's original 1995 analysis, have been criticized by some within the scientific community, despite reports of its usefulness in the popular press.

Predictive power

Landy distinguishes between the "commercial" and "academic" discussion of EI, basing this distinction on the alleged predictive power of EI as seen by each of the two. According to Landy, the former makes expansive claims on the applied value of EI, while the latter is trying to warn users against these claims. As an example, Goleman (1998) asserts that "the most effective leaders are alike in one crucial way: they all have a high degree of what has come to be known as emotional intelligence. ...emotional intelligence is the sine qua non of leadership". In contrast, Mayer (1999) cautions "the popular literature's implication—that highly emotionally intelligent people possess an unqualified advantage in life—appears overly enthusiastic at present and unsubstantiated by reasonable scientific standards." Landy further reinforces this argument by noting that the data upon which these claims are based are held in "proprietary databases", which means they are unavailable to independent researchers for reanalysis, replication, or verification. Furthermore, Murensky (2000) states it is difficult to create objective measures of emotional intelligence and demonstrate its influence on leadership as many scales are self-report measures.

In an academic exchange, Antonakis and Ashkanasy/Dasborough mostly agreed that researchers testing whether EI matters for leadership have not done so using robust research designs; therefore, currently there is no strong evidence showing that EI predicts leadership outcomes when accounting for personality and IQ. Antonakis argued that EI might not be needed for leadership effectiveness (he referred to this as the "curse of emotion" phenomenon, because leaders who are too sensitive to their and others' emotional states might have difficulty making decisions that would result in emotional labor for the leader or followers). A 2010 meta-analysis seems to support the Antonakis position: In fact, Harms and Credé found that overall (and using data free from problems of common source and common methods), EI measures correlated only ρ = 0.11 with measures of transformational leadership. Barling, Slater, and Kelloway (2000) also support Harms and Crede's position on transformational leadership.

Ability-measures of EI fared worst (i.e., ρ = 0.04); the WLEIS (Wong-Law measure) did a bit better (ρ = 0.08), and the Bar-On measure slightly better (ρ = 0.18). However, the validity of these estimates does not include the effects of IQ or the big five personality, which correlate both with EI measures and leadership. In a subsequent paper analyzing the impact of EI on both job performance and leadership, Harms and Credé found that the meta-analytic validity estimates for EI dropped to zero when Big Five traits and IQ were controlled for. Joseph and Newman meta-analytically showed the same result for Ability EI.

However, self-reported and Trait EI measures retain a fair amount of predictive validity for job performance after controlling Big Five traits and IQ. Newman, Joseph, and MacCann contend that the greater predictive validity of Trait EI measures is due to their inclusion of content related to achievement motivation, self efficacy, and self-rated performance. Meta-analytic evidence confirms that self-reported emotional intelligence predicting job performance is due to mixed EI and trait EI measures' tapping into self-efficacy and self-rated performance, in addition to the domains of Neuroticism, Extraversion, Conscientiousness, and IQ. As such, the predictive ability of mixed EI to job performance drops to nil when controlling for these factors.

Rosete and Ciarrochi (2005) also explored the predictive ability of EI and job performance. They concluded that higher EI was associated with higher leadership effectiveness regarding achievement of organizational goals. Their study shows EI may serve an identifying tool in understanding who is (or is not) likely to deal effectively with colleagues. Furthermore, there exists the ability to develop and enhance leadership qualities through the advancement of one's emotional intelligence. Groves, McEnrue, and Shen (2008) found EI can be deliberately developed, specifically facilitating thinking with emotions (FT) and monitoring and regulation of emotions (RE) in the workplace.

Correlation with personality

Similarly, other researchers have raised concerns about the extent to which self-report EI measures correlate with established personality dimensions. Generally, self-report EI measures and personality measures have been said to converge because they both purport to measure personality traits.

Specifically, there appear to be two dimensions of the Big Five that stand out as most related to self-report EI – neuroticism and extraversion. In particular, neuroticism has been said to relate to negative emotionality and anxiety. Intuitively, individuals scoring high on neuroticism are likely to score low on self-report EI measures.

Studies have examined the multivariate effects of personality and intelligence on EI and also attempted to correct estimates for measurement error. For example, a study by Schulte, Ree, Carretta (2004), showed that general intelligence (measured with the Wonderlic Personnel Test), agreeableness (measured by the NEO-PI), as well as gender could reliably be used to predict the measure of EI ability. They gave a multiple correlation (R) of .81 with the MSCEIT (perfect prediction would be 1). This result has been replicated by Fiori and Antonakis (2011); they found a multiple R of .76 using Cattell's "Culture Fair" intelligence test and the Big Five Inventory (BFI); significant covariates were intelligence (standardized beta = .39), agreeableness (standardized beta = .54), and openness (standardized beta = .46). Antonakis and Dietz (2011a), who investigated the Ability Emotional Intelligence Measure found similar results (Multiple R = .69), with significant predictors being intelligence, standardized beta = .69 (using the Swaps Test and a Wechsler scales subtest, the 40-item General Knowledge Task) and empathy, standardized beta = .26 (using the Questionnaire Measure of Empathic Tendency). Antonakis and Dietz (2011b) also show how including or excluding important controls variables can fundamentally change results.

Interpretations of the correlations between EI questionnaires and personality have been varied, but a prominent view in the scientific literature is the Trait EI view, which re-interprets EI as a collection of personality traits.

A 2011 meta-analysis classified EI studies into three streams: "(1) ability‐based models that use objective test items; (2) self‐report or peer‐report measures based on the four‐branch model of EI; and (3) “mixed models” of emotional competencies." It found that these "three streams have corrected correlations ranging from 0.24 to 0.30 with job performance. The three streams correlated differently with cognitive ability and with neuroticism, extraversion, openness, agreeableness, and conscientiousness. Streams 2 and 3 have the largest incremental validity beyond cognitive ability and the Five Factor Model (FFM)." The meta-analysis concluded that "all three streams of EI exhibited substantial relative importance in the presence of FFM and intelligence when predicting job performance." A follow-up meta-analysis in 2015 further substantiated these findings, and addressed concerns about "the questionable construct validity of mixed EI measures" by arguing that "mixed EI instruments assess a combination of ability EI and self-perceptions, in addition to personality and cognitive ability."

Socially desirable responding

Socially desirable responding (SDR), or "faking good", is defined as a response pattern in which test-takers systematically represent themselves with an excessive positive bias (Paulhus, 2002). This bias has long been known to contaminate responses on personality inventories (Holtgraves, 2004; McFarland & Ryan, 2000; Peebles & Moore, 1998; Nichols & Greene, 1997; Zerbe & Paulhus, 1987), acting as a mediator of the relationships between self-report measures (Nichols & Greene, 1997; Gangster et al., 1983).

It has been suggested that responding in a desirable way is a response set, which is a situational and temporary response pattern (Pauls & Crost, 2004; Paulhus, 1991). This is contrasted with a response style, which is a more long-term trait-like quality. Considering the contexts some self-report EI inventories are used in (e.g., employment settings), the problems of response sets in high-stakes scenarios become clear (Paulhus & Reid, 2001).

There are a few methods to prevent socially desirable responding on behavior inventories. Some researchers believe it is necessary to warn test-takers not to fake good before taking a personality test (e.g., McFarland, 2003). Some inventories use validity scales in order to determine the likelihood or consistency of the responses across all items.

EI as behavior rather than intelligence

Goleman's early work has been criticized for assuming from the beginning that EI is a type of intelligence or cognitive ability. Eysenck (2000) writes that Goleman's description of EI contains unsubstantiated assumptions about intelligence in general and that it even runs contrary to what researchers have come to expect when studying types of intelligence:

"[Goleman] exemplifies more clearly than most the fundamental absurdity of the tendency to class almost any type of behavior as an 'intelligence'... If these five 'abilities' define 'emotional intelligence', we would expect some evidence that they are highly correlated; Goleman admits that they might be quite uncorrelated, and in any case, if we cannot measure them, how do we know they are related? So the whole theory is built on quicksand: there is no sound scientific basis."

Similarly, Locke (2005) claims that the concept of EI is in itself a misinterpretation of the intelligence construct, and he offers an alternative interpretation: it is not another form or type of intelligence, but intelligence—the ability to grasp abstractions—applied to a particular life domain: emotions. He suggests the concept should be re-labeled and referred to as a skill.

The essence of this criticism is that scientific inquiry depends on valid and consistent construct utilization and that before the introduction of the term EI, psychologists had established theoretical distinctions between factors such as abilities and achievements, skills and habits, attitudes and values, and personality traits and emotional states. Thus, some scholars believe that the term EI merges and conflates such accepted concepts and definitions.

EI as skill rather than moral quality

Adam Grant warned of the common but mistaken perception of EI as a desirable moral quality rather than a skill. Grant asserted that a well-developed EI is not only an instrumental tool for accomplishing goals, but can function as a weapon for manipulating others by robbing them of their capacity to reason.

EI as a measure of conformity

Tom Reed describes four stages of emotional intelligence: self-awareness, social consciousness, self-care and relationship management, as part of NAVAIR’s “Mentoring at the Speed of Life” event

One criticism of the works of Mayer and Salovey comes from a study by Roberts et al. (2001), which suggests that the EI, as measured by the MSCEIT, may only be measuring conformity. This argument is rooted in the MSCEIT's use of consensus-based assessment, and in the fact that scores on the MSCEIT are negatively distributed (meaning that its scores differentiate between people with low EI better than people with high EI).

EI as a form of knowledge

Further criticism has been leveled by Brody (2004), who claimed that unlike tests of cognitive ability, the MSCEIT "tests knowledge of emotions but not necessarily the ability to perform tasks that are related to the knowledge that is assessed". The main argument is that even though someone knows how he or she should behave in an emotionally laden situation, it doesn't necessarily follow that the person could actually carry out the reported behavior.

NICHD pushes for consensus

The National Institute of Child Health and Human Development has recognized that because there are divisions about the topic of emotional intelligence, the mental health community needs to agree on some guidelines to describe good mental health and positive mental living conditions. In their section, "Positive Psychology and the Concept of Health", they explain. "Currently there are six competing models of positive health, which are based on concepts such as being above normal, character strengths and core virtues, developmental maturity, social-emotional intelligence, subjective well-being, and resilience. But these concepts define health in philosophical rather than empirical terms. Dr. [Lawrence] Becker suggested the need for a consensus on the concept of positive psychological health...".

Interactions with other phenomena

Bullying

Bullying is abusive social interaction between peers which can include aggression, harassment, and violence. Bullying is typically repetitive and enacted by those who are in a position of power over the victim. A growing body of research illustrates a significant relationship between bullying and emotional intelligence. They also have shown that emotional intelligence is a key factor in the analysis of cases of cybervictimization, by demonstrating a relevant impact on health and social adaptation.

Emotional intelligence (EI) is a set of abilities related to the understanding, use and management of emotion as it relates to one's self and others. Mayer et al., (2008) defines the dimensions of overall EI as: "accurately perceiving emotion, using emotions to facilitate thought, understanding emotion, and managing emotion". The concept combines emotional and intellectual processes. Lower emotional intelligence appears to be related to involvement in bullying, as the bully and/or the victim of bullying. EI seems to play an important role in both bullying behavior and victimization in bullying; given that EI is illustrated to be malleable, EI education could greatly improve bullying prevention and intervention initiatives.

Job performance

The most recent meta-analysis of emotional intelligence and job performance showed correlations of r=.20 (for job performance & ability EI) and r=.29 (for job performance and mixed EI). Earlier research on EI and job performance had shown mixed results: a positive relation has been found in some of the studies, while in others there was no relation or an inconsistent one. This led researchers Cote and Miners (2006) to offer a compensatory model between EI and IQ, that posits that the association between EI and job performance becomes more positive as cognitive intelligence decreases, an idea first proposed in the context of academic performance (Petrides, Frederickson, & Furnham, 2004). The results of the former study supported the compensatory model: employees with low IQ get higher task performance and organizational citizenship behavior directed at the organization, the higher their EI. It has also been observed that there is no significant link between emotional intelligence and work attitude-behavior.

A more recent study suggests that EI is not necessarily a universally positive trait. They found a negative correlation between EI and managerial work demands; while under low levels of managerial work demands, they found a negative relationship between EI and teamwork effectiveness. An explanation for this may suggest gender differences in EI, as women tend to score higher levels than men. This furthers the idea that job context plays a role in the relationships between EI, teamwork effectiveness, and job performance. Another find was discussed in a study that assessed a possible link between EI and entrepreneurial behaviors and success.

Although studies between emotional intelligence (EI) and job performance have shown mixed results of high and low correlations, EI is an undeniably better predictor than most of the hiring methods commonly used in companies, such as letter of references, cover letter, among others. By 2008, 147 companies and consulting firms in U.S had developed programmes that involved EI for training and hiring employees. Van Rooy and Viswesvaran (2004) showed that EI correlated significantly with different domains in performance, ranging from .24 for job performance to .10 for academic performance. These findings may contribute to organizations in different ways. For instance, employees high on EI would be more aware of their own emotions and from others, which in turn, could lead companies to better profits and less unnecessary expenses. This is especially important for expatriate managers, who have to deal with mixed emotions and feelings, while adapting to a new working culture. Moreover, employees high in EI show more confidence in their roles, which allow them to face demanding tasks positively.

According to a popular science book by the journalist Daniel Goleman, emotional intelligence accounts for more career success than IQ. Similarly, other studies argued that employees high on EI perform substantially better than employees low in EI. This is measured by self-reports and different work performance indicators, such as wages, promotions and salary increase. According to Lopes and his colleagues (2006), EI contributes to develop strong and positive relationships with co-workers and perform efficiently in work teams. This benefits performance of workers by providing emotional support and instrumental resources needed to succeed in their roles. Also, emotionally intelligent employees have better resources to cope with stressing situations and demanding tasks, which enable them to outperform in those situations. For instance, Law et al. (2004) found that EI was the best predictor of job performance beyond general cognitive ability among IT scientists in computer company in China. Similarly, Sy, Tram, and O’Hara (2006) found that EI was associated positively with job performance in employees from a food service company.

In the job performance – emotional intelligence correlation is important to consider the effects of managing up, which refers to the good and positive relationship between the employee and his/her supervisor. Previous research found that quality of this relationship could interfere in the results of the subjective rating of job performance evaluation. Emotionally intelligent employees devote more of their working time on managing their relationship with supervisors. Hence, the likelihood of obtaining better results on performance evaluation is greater for employees high in EI than for employees with low EI. Based on theoretical and methodological approaches, EI measures are categorized in three main streams: (1) stream 1: ability-based measures (e.g. MSCEIT), (2) stream 2: self-reports of abilities measures (e.g. SREIT, SUEIT and WLEIS) and (3) stream 3: mixed-models (e.g. AES, ECI, EI questionnaire, EIS, EQ-I and GENOS), which include measures of EI and traditional social skills. O’Boyle Jr. and his colleagues (2011) found that the three EI streams together had a positive correlation of 0.28 with job performance. Similarly, each of EI streams independently obtained a positive correlation of 0.24, 0.30 and 0.28, respectively. Stream 2 and 3 showed an incremental validity for predicting job performance over and above personality (Five Factor model) and general cognitive ability. Both, stream 2 and 3 were the second most important predictor of job performance below general cognitive ability. Stream 2 explained 13.6% of the total variance; whereas stream 3, explained 13.2%. In order to examine the reliability of these findings, a publication bias analysis was developed. Results indicated that studies on EI-job performance correlation prior to 2010 do not present substantial evidences to suggest the presence of publication bias. Noting that O'Boyle Jr. et al. (2011) had included self-rated performance and academic performance in their meta-analysis, Joseph, Jin, Newman, & O'Boyle (2015) collaborated to update the meta-analysis to focus specifically on job performance; using measures of job performance, these authors showed r=.20 (for job performance & ability EI) and r=.29 (for job performance and mixed EI).

Despite the validity of previous findings, some researchers still question whether EI – job performance correlation makes a real impact on business strategies. They argue that the popularity of EI studies is due to media advertising, rather than objective scientific findings. Also, it is mentioned that the relationship between job performance and EI is not as strong as suggested. This relationship requires the presence of other constructs to raise important outcomes. For instance, previous studies found that EI is positively associated with teamwork effectiveness under job contexts of high managerial work demands, which improves job performance. This is due to the activation of strong emotions during the performance on this job context. In this scenario, emotionally intelligent individuals show a better set of resources to succeed in their roles. However, individuals with high EI show a similar level of performance than non-emotionally intelligent employees under different job contexts. Moreover, Joseph and Newman (2010) suggested that emotional perception and emotional regulation components of EI highly contribute to job performance under job contexts of high emotional demands. Moon and Hur (2011) found that emotional exhaustion (“burn-out”) significantly influences the job performance – EI relationship. Emotional exhaustion showed a negative association with two components of EI (optimism and social skills). This association impacted negatively to job performance, as well. Hence, job performance – EI relationship is stronger under contexts of high emotional exhaustion or burn-out; in other words, employees with high levels of optimism and social skills possess better resources to outperform when facing high emotional exhaustion contexts.

Leadership

There are several studies that attempt to study the relationship between EI and leadership. Although EI does play a positive role when it comes to leadership effectiveness, what actually makes a leader effective is what he/she does with his role, rather than his interpersonal skills and abilities. Although in the past a good or effective leader was the one who gave orders and controlled the overall performance of the organization, almost everything is different nowadays: leaders are now expected to motivate and create a sense of belongingness that will make employees feel comfortable, thus, making them work more effectively.

However, this does not mean that actions are more important than emotional intelligence. Leaders still need to grow emotionally in order to handle different problems of stress, and lack of life balance, among other things. A proper way to grow emotionally, for instance, is developing a sense of empathy since empathy is a key factor when it comes to emotional intelligence. In a study conducted to analyze the relationship between School Counselors' EI and leadership skills, it was concluded that several participants were good leaders because their emotional intelligence was developed in counselor preparations, where empathy is taught.

Health

A 2007 meta-analysis of 44 effect sizes by Schutte found that emotional intelligence was associated with better mental and physical health. Particularly, trait EI had the stronger association with mental and physical health. This was replicated again in 2010 by researcher Alexandra Martin who found trait EI as a strong predictor for health after conducting a meta-analysis based on 105 effect sizes and 19,815 participants. This meta-analysis also indicated that this line of research reached enough sufficiency and stability in concluding EI as a positive predictor for health.

An earlier study by Mayer and Salovsky argued that high EI can increase one's own well-being because of its role in enhancing relationships.

Self-esteem and drug dependence

A 2012 study cross-examined emotional intelligence, self-esteem and marijuana dependence. Out of a sample of 200, 100 of whom were dependent on cannabis and the other 100 emotionally healthy, the dependent group scored exceptionally low on EI when compared to the control group. They also found that the dependent group also scored low on self-esteem when compared to the control.

Another study in 2010 examined whether or not low levels of EI had a relationship with the degree of drug and alcohol addiction. In the assessment of 103 residents in a drug rehabilitation center, they examined their EI along with other psychosocial factors in a one-month interval of treatment. They found that participants' EI scores improved as their levels of addiction lessened as part of their treatment.