Search This Blog

Thursday, September 5, 2024

Aneurysm

From Wikipedia, the free encyclopedia
 

An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus (starting point) for clot formation (thrombosis) and embolization. As an aneurysm increases in size, the risk of rupture, which leads to uncontrolled bleeding, increases. Although they may occur in any blood vessel, particularly lethal examples include aneurysms of the circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can arise in the heart itself following a heart attack, including both ventricular and atrial septal aneurysms. There are congenital atrial septal aneurysms, a rare heart defect.

Etymology

The word is from Greek: ἀνεύρυσμα, aneurysma, "dilation", from ἀνευρύνειν, aneurynein, "to dilate".

Classification

Aneurysms are classified by type, morphology, or location.

True and false aneurysms

A true aneurysm is one that involves all three layers of the wall of an artery (intima, media and adventitia). True aneurysms include atherosclerotic, syphilitic, and congenital aneurysms, as well as ventricular aneurysms that follow transmural myocardial infarctions (aneurysms that involve all layers of the attenuated wall of the heart are also considered true aneurysms).

A false aneurysm, or pseudoaneurysm, is a collection of blood leaking completely out of an artery or vein but confined next to the vessel by the surrounding tissue. This blood-filled cavity will eventually either thrombose (clot) enough to seal the leak or rupture out of the surrounding tissue.

Pseudoaneurysms can be caused by trauma that punctures the artery, such as knife and bullet wounds, as a result of percutaneous surgical procedures such as coronary angiography or arterial grafting, or use of an artery for injection.

Morphology

Cross-section of an arterial aneurysm, showing most of the area consisting of organized mural thrombus (tan-brown area)

Aneurysms can also be classified by their macroscopic shapes and sizes and are described as either saccular or fusiform. The shape of an aneurysm is not specific for a specific disease. The size of the base or neck is useful in determining the chance of for example endovascular coiling.

Saccular aneurysms, or "berry" aneurysms, are spherical in shape and involve only a portion of the vessel wall; they usually range from 5 to 20 cm (2.0 to 7.9 in) in diameter, and are often filled, either partially or fully, by a thrombus.Saccular aneurysms have a "neck" that connects the aneurysm to its main ("parent") artery, a larger, rounded area, called the dome.

Fusiform aneurysms ("spindle-shaped" aneurysms) are variable in both their diameter and length; their diameters can extend up to 20 cm (7.9 in). They often involve large portions of the ascending and transverse aortic arch, the abdominal aorta, or, less frequently, the iliac arteries.

Location

Aneurysms can also be classified by their location:

Ultrasonography of an aneurysm of the great saphenous vein due to venous valve insufficiency.

Cerebral aneurysms, also known as intracranial or brain aneurysms, occur most commonly in the anterior cerebral artery, which is part of the circle of Willis. This can cause severe strokes leading to death. The next most common sites of cerebral aneurysm occurrence are in the internal carotid artery.

Size

Abdominal aorta size classification
Ectatic or
mild dilatation
>2.0 cm and <3.0 cm
Moderate 3.0–5.0 cm
Large or severe >5.0 or 5.5 cm

Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm), or more than 50% of normal diameter that of a healthy individual of the same sex and age. If the outer diameter exceeds 5.5 cm, the aneurysm is considered to be large.

The common iliac artery is classified as:

Normal Diameter ≤12 mm
Ectatic Diameter 12 to 18 mm
Aneurysm Diameter ≥18 mm

Signs and symptoms

Aneurysm presentation may range from life-threatening complications of hypovolemic shock to being found incidentally on X-ray. Symptoms will differ by the site of the aneurysm and can include:

Cerebral aneurysm

Symptoms can occur when the aneurysm pushes on a structure in the brain. Symptoms will depend on whether an aneurysm has ruptured or not. There may be no symptoms present at all until the aneurysm ruptures. For an aneurysm that has not ruptured the following symptoms can occur:

For a ruptured aneurysm, symptoms of a subarachnoid hemorrhage may present:

  • Severe headaches
  • Loss of vision
  • Double vision
  • Neck pain or stiffness
  • Pain above or behind the eyes

Abdominal aneurysm

Illustration depicting location of abdominal aneurysm
3D model of aortic aneurism

Abdominal aortic aneurysm involves a regional dilation of the aorta and is diagnosed using ultrasonography, computed tomography, or magnetic resonance imaging. A segment of the aorta that is found to be greater than 50% larger than that of a healthy individual of the same sex and age is considered aneurysmal. Abdominal aneurysms are usually asymptomatic but in rare cases can cause lower back pain or lower limb ischemia.

Renal (kidney) aneurysm

  • Flank pain and tenderness
  • Hypertension
  • Haematuria
  • Signs of hypovolemic shock

Risk factors

Risk factors for an aneurysm include diabetes, obesity, hypertension, tobacco use, alcoholism, high cholesterol, copper deficiency, increasing age, and tertiary syphilis infection. Connective tissue disorders such as Loeys-Dietz syndrome, Marfan syndrome, and certain forms of Ehlers-Danlos syndrome are also associated with aneurysms. Aneurysms, dissections, and ruptures in individuals under 40 years of age are a major diagnostic criteria of the vascular form of Ehlers-Danlos syndrome (vEDS).

Specific infective causes associated with aneurysm include:

A minority of aneurysms are associated with genetic factors. Examples include:

Pathophysiology

Aneurysms form for a variety of interacting reasons. Multiple factors, including factors affecting a blood vessel wall and the blood through the vessel, contribute.

The pressure of blood within the expanding aneurysm may also injure the blood vessels supplying the artery itself, further weakening the vessel wall. Without treatment, these aneurysms will ultimately progress and rupture.

Infection. A mycotic aneurysm is an aneurysm that results from an infectious process that involves the arterial wall. A person with a mycotic aneurysm has a bacterial infection in the wall of an artery, resulting in the formation of an aneurysm. One of the causes of mycotic aneurysms is infective endocarditis. The most common locations include arteries in the abdomen, thigh, neck, and arm. A mycotic aneurysm can result in sepsis, or life-threatening bleeding if the aneurysm ruptures. Less than 3% of abdominal aortic aneurysms are mycotic aneurysms.

Syphilis. The third stage of syphilis also manifests as aneurysm of the aorta, which is due to loss of the vasa vasorum in the tunica adventitia.

Copper deficiency. A minority of aneurysms are caused by copper deficiency, which results in a decreased activity of the lysyl oxidase enzyme, affecting elastin, a key component in vessel walls. Copper deficiency results in vessel wall thinning, and thus has been noted as a cause of death in copper-deficient humans, chickens, and turkeys.

Mechanics

Aneurysmal blood vessels are prone to rupture under normal blood pressure and flow due to the special mechanical properties that make them weaker. To better understand this phenomenon, we can first look at healthy arterial vessels which exhibit a J-shaped stress-strain curve with high strength and high toughness (for a biomaterial in vivo). Unlike crystalline materials whose linear elastic region follows Hooke's Law under uniaxial loading, many biomaterials exhibit a J-shaped stress-strain curve which is non-linear and concave up. The blood vessel can be under large strain, or the amount of stretch the blood vessel can undergo, for a range of low applied stress before fracture, as shown by the lower part of the curve. The area under the curve up to a given strain is much lower than that for the equivalent Hookean curve, which is correlated to toughness. Toughness is defined as the amount of energy per unit volume material can absorb before rupturing. Because the amount of energy released is proportional to the amount of crack propagation, the blood vessel wall can withstand pressure and is "tough". Thus, healthy blood vessels with the mechanical properties of the J-shaped stress-strain curve have greater stability against aneurysms than materials with linear elasticity.

Blood vessels with aneurysms, on the other hand, are under the influence of an S-shaped stress-strain curve. As a visual aid, aneurysms can be understood as a long, cylindrical balloon. Because it's a tight balloon under pressure, it can pop at any time stress beyond a certain force threshold is applied. In the same vein, an unhealthy blood vessel has elastic instabilities that lead to rupture. Initially, for a given radius and pressure, stiffness of the material increases linearly. At a certain point, the stiffness of the arterial wall starts to decrease with increasing load. At higher strain values, the area under the curve increases, thus increasing the impact on the material that would promote crack propagation. The differences in the mechanical properties of the aneurysmal blood vessels and the healthy blood vessels stem from the compositional differences of the vessels. Compared to normal aortas, aneurysmal aortas have a much higher volume fraction of collagen and ground substance (54.8% vs. 95.6%) and a much lower volume fraction of elastin (22.7% vs. 2.4%) and smooth muscles (22.6% vs. 2.2%), which contribute to higher initial stiffness. It was also found that the ultimate tensile strength, or the strength to withstand rupture, of aneurysmal vessel wall is 50% lower than that of normal aortas. The wall strength of ruptured aneurysmal aortic wall was also found to be 54.2 N/cm2, which is much lower than that of a repaired aorta wall, 82.3 N/cm2. Due to the change in composition of the arterial wall, aneurysms overall have much lower strength to resist rupture. Predicting the risk of rupture is difficult due to the regional anisotropy the hardened blood vessels exhibit, meaning that the stress and strength values vary depending on the region and the direction of the vessel they are measured along.

Diagnosis

Ruptured 7 mm left vertebral artery aneurysm resulting in a subarachnoid hemorrhage as seen on a CT scan with contrast

Diagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid hemorrhage on a computed tomography (CT) scan. If the CT scan is negative but a ruptured aneurysm is still suspected based on clinical findings, a lumbar puncture can be performed to detect blood in the cerebrospinal fluid. Computed tomography angiography (CTA) is an alternative to traditional angiography and can be performed without the need for arterial catheterization. This test combines a regular CT scan with a contrast dye injected into a vein. Once the dye is injected into a vein, it travels to the cerebral arteries, and images are created using a CT scan. These images show exactly how blood flows into the brain arteries.

Treatment

Historically, the treatment of arterial aneurysms has been limited to either surgical intervention or watchful waiting in combination with control of blood pressure. At least, in the case of abdominal aortic aneurysm (AAA), the decision does not come without significant risk and cost, hence, there is a great interest in identifying more advanced decision-making approaches that are not solely based on the AAA diameter, but involve other geometrical and mechanical nuances such as local thickness and wall stress. In recent years, endovascular or minimally invasive techniques have been developed for many types of aneurysms. Aneurysm clips are used for surgical procedure i.e. clipping of aneurysms.

Intracranial

There are currently two treatment options for brain aneurysms: surgical clipping or endovascular coiling. There is currently debate in the medical literature about which treatment is most appropriate given particular situations.

Surgical clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937. It consists of a craniotomy to expose the aneurysm and closing the base or neck of the aneurysm with a clip. The surgical technique has been modified and improved over the years.

Endovascular coiling was introduced by Italian neurosurgeon Guido Guglielmi at UCLA in 1989. It consists of passing a catheter into the femoral artery in the groin, through the aorta, into the brain arteries, and finally into the aneurysm itself. Platinum coils initiate a clotting reaction within the aneurysm that, if successful, fills the aneurysm dome and prevents its rupture. A flow diverter can be used, but risks complications.

Aortic and peripheral

Endovascular stent and endovascular coil

For aneurysms in the aorta, arms, legs, or head, the weakened section of the vessel may be replaced by a bypass graft that is sutured at the vascular stumps. Instead of sewing, the graft tube ends, made rigid and expandable by nitinol wireframe, can be easily inserted in its reduced diameter into the vascular stumps and then expanded up to the most appropriate diameter and permanently fixed there by external ligature. New devices were recently developed to substitute the external ligature by expandable ring allowing use in acute ascending aorta dissection, providing airtight (i.e. not dependent on the coagulation integrity), easy and quick anastomosis extended to the arch concavity Less invasive endovascular techniques allow covered metallic stent grafts to be inserted through the arteries of the leg and deployed across the aneurysm.

Renal

Renal aneurysms are very rare consisting of only 0.1–0.09% while rupture is even more rare. Conservative treatment with control of concomitant hypertension being the primary option with aneurysms smaller than 3 cm. If symptoms occur, or enlargement of the aneurysm, then endovascular or open repair should be considered. Pregnant women (due to high rupture risk of up to 80%) should be treated surgically.

Epidemiology

Incidence rates of cranial aneurysms are estimated at between 0.4% and 3.6%. Those without risk factors have expected prevalence of 2–3%. In adults, females are more likely to have aneurysms. They are most prevalent in people ages 35 – 60 but can occur in children as well. Aneurysms are rare in children with a reported prevalence of .5% to 4.6%. The most common incidence is among 50-year-olds, and there are typically no warning signs. Most aneurysms develop after the age of 40. 

Pediatric aneurysms

Pediatric aneurysms have different incidences and features than adult aneurysms. Intracranial aneurysms are rare in childhood, with over 95% of all aneurysms occurring in adults.

Risk factors

Incidence rates are two to three times higher in males, while there are more large and giant aneurysms and fewer multiple aneurysms. Intracranial hemorrhages are 1.6 times more likely to be due to aneurysms than cerebral arteriovenous malformations in whites, but four times less in certain Asian populations.

Most patients, particularly infants, present with subarachnoid hemorrhage and corresponding headaches or neurological deficits. The mortality rate for pediatric aneurysms is lower than in adults.

Modeling

Vortex formation inside an aneurysm. 1- Blood flow inlet. 2- Vortex formation inside aneurysm. Velocity at center is near zero. 3- Blood flow exit

Modeling of aneurysms consists of creating a 3D model that mimics a particular aneurysm. Using patient data for the blood velocity, and blood pressure, along with the geometry of the aneurysm, researchers can apply computational fluid dynamics (CFD) to predict whether an aneurysm is benign or if it is at risk of complication. One risk is rupture. Analyzing the velocity and pressure profiles of the blood flow leads to obtaining the resulting wall shear stress on the vessel and aneurysm wall. The neck of the aneurysm is the most at risk due to the combination of a small wall thickness and high wall shear stress. When the wall shear stress reaches its limit, the aneurysm ruptures, leading to intracranial hemorrhage. Conversely, another risk of aneurysms is the creation of clots. Aneurysms create a pocket which diverts blood flow. This diverted blood flow creates a vortex inside of the aneurysm. This vortex can lead to areas inside of the aneurysm where the blood flow is stagnant, which promotes formations of clots. Blood clots can dislodge from the aneurysm, which can then lead to an embolism when the clot gets stuck and disrupts blood flow. Model analysis allows these risky aneurysms to be identified and treated.

In the past, aneurysms were modeled as rigid spheres with linear inlets and outlets. As technology advances, the ability to detect and analyze aneurysms becomes easier. Researchers are able to CT scan a patient's body to create a 3D computer model that possesses the correct geometry. Aneurysms can now be modeled with their distinctive "balloon" shape. Nowadays researchers are optimizing the parameters required to accurately model a patient's aneurysm that will lead to a successful intervention. Current modeling is not able to take into account all variables though. For example, blood is considered to be a non-Newtonian fluid. Some researchers treat blood as a Newtonian fluid instead, as it sometimes has negligible effects to the analysis in large vessels. When analyzing small vessels though, such as those present in intracranial aneurysms. Similarly, sometimes it is difficult to model the varying wall thickness in small vessels, so researchers treat wall thickness as constant. Researchers make these assumptions to reduce computational time. Nonetheless, making erroneous assumptions could lead to a misdiagnosis that could put a patient's life at risk.

Bleeding

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Bleeding

Bleeding
Other namesHemorrhaging, haemorrhaging, blood loss
A bleeding wound in the finger

Bleeding, hemorrhage, haemorrhage or blood loss is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery.

Types

Causes

Bleeding arises due to either traumatic injury, underlying medical condition, or a combination.

Traumatic injury

Traumatic bleeding is caused by some type of injury. There are different types of wounds which may cause traumatic bleeding. These include:

  • Abrasion — Also called a graze, this is caused by transverse action of a foreign object against the skin, and usually does not penetrate below the epidermis.
  • Excoriation — In common with Abrasion, this is caused by mechanical destruction of the skin, although it usually has an underlying medical cause.
  • Hematoma — Caused by damage to a blood vessel that in turn causes blood to collect in an enclosed area.
  • Laceration — Irregular wound caused by blunt impact to soft tissue overlying hard tissue or tearing such as in childbirth. In some instances, this can also be used to describe an incision.
  • Incision — A cut into a body tissue or organ, such as by a scalpel, made during surgery.
  • Puncture Wound — Caused by an object that penetrated the skin and underlying layers, such as a nail, needle or knife.
  • Contusion — Also known as a bruise, this is a blunt trauma damaging tissue under the surface of the skin.
  • Crushing Injuries — Caused by a great or extreme amount of force applied over a period of time. The extent of a crushing injury may not immediately present itself.
  • Ballistic Trauma — Caused by a projectile weapon such as a firearm. This may include two external wounds (entry and exit) and a contiguous wound between the two.

The pattern of injury, evaluation and treatment will vary with the mechanism of the injury. Blunt trauma causes injury via a shock effect; delivering energy over an area. Wounds are often not straight and unbroken skin may hide significant injury. Penetrating trauma follows the course of the injurious device. As the energy is applied in a more focused fashion, it requires less energy to cause significant injury. Any body organ, including bone and brain, can be injured and bleed. Bleeding may not be readily apparent; internal organs such as the liver, kidney and spleen may bleed into the abdominal cavity. The only apparent signs may come with blood loss. Bleeding from a bodily orifice, such as the rectum, nose, or ears may signal internal bleeding, but cannot be relied upon. Bleeding from a medical procedure also falls into this category.

Medical condition

"Medical bleeding" denotes hemorrhage as a result of an underlying medical condition (i.e. causes of bleeding that are not directly due to trauma). Blood can escape from blood vessels as a result of 3 basic patterns of injury:

The underlying scientific basis for blood clotting and hemostasis is discussed in detail in the articles, coagulation, hemostasis and related articles. The discussion here is limited to the common practical aspects of blood clot formation which manifest as bleeding.

Some medical conditions can also make patients susceptible to bleeding. These are conditions that affect the normal hemostatic (bleeding-control) functions of the body. Such conditions either are, or cause, bleeding diatheses. Hemostasis involves several components. The main components of the hemostatic system include platelets and the coagulation system.

Platelets are small blood components that form a plug in the blood vessel wall that stops bleeding. Platelets also produce a variety of substances that stimulate the production of a blood clot. One of the most common causes of increased bleeding risk is exposure to nonsteroidal anti-inflammatory drugs (NSAIDs). The prototype for these drugs is aspirin, which inhibits the production of thromboxane. NSAIDs (for example Ibuprofen) inhibit the activation of platelets, and thereby increase the risk of bleeding. The effect of aspirin is irreversible; therefore, the inhibitory effect of aspirin is present until the platelets have been replaced (about ten days). Other NSAIDs, such as "ibuprofen" (Motrin) and related drugs, are reversible and therefore, the effect on platelets is not as long-lived.

There are several named coagulation factors that interact in a complex way to form blood clots, as discussed in the article on coagulation. Deficiencies of coagulation factors are associated with clinical bleeding. For instance, deficiency of Factor VIII causes classic hemophilia A while deficiencies of Factor IX cause "Christmas disease"(hemophilia B). Antibodies to Factor VIII can also inactivate the Factor VII and precipitate bleeding that is very difficult to control. This is a rare condition that is most likely to occur in older patients and in those with autoimmune diseases. Another common bleeding disorder is Von Willebrand disease. It is caused by a deficiency or abnormal function of the "Von Willebrand" factor, which is involved in platelet activation. Deficiencies in other factors, such as factor XIII or factor VII are occasionally seen, but may not be associated with severe bleeding and are not as commonly diagnosed.

In addition to NSAID-related bleeding, another common cause of bleeding is that related to the medication, warfarin ("Coumadin" and others). This medication needs to be closely monitored as the bleeding risk can be markedly increased by interactions with other medications. Warfarin acts by inhibiting the production of Vitamin K in the gut. Vitamin K is required for the production of the clotting factors, II, VII, IX, and X in the liver. One of the most common causes of warfarin-related bleeding is taking antibiotics. The gut bacteria make vitamin K and are killed by antibiotics. This decreases vitamin K levels and therefore the production of these clotting factors.

Deficiencies of platelet function may require platelet transfusion while deficiencies of clotting factors may require transfusion of either fresh frozen plasma or specific clotting factors, such as Factor VIII for patients with hemophilia.

Infection

Infectious diseases such as Ebola, Marburg virus disease and yellow fever can cause bleeding.

Diagnosis/Imaging

Dioxaborolane chemistry enables radioactive fluoride (18F) labeling of red blood cells, which allows for positron emission tomography (PET) imaging of intracerebral hemorrhages.

Classification

A subconjunctival hemorrhage is a common and relatively minor post-LASIK complication.
Micrograph showing abundant hemosiderin-laden alveolar macrophages (dark brown), as seen in a pulmonary hemorrhage. H&E stain.

Blood loss

Hemorrhaging is broken down into four classes by the American College of Surgeons' advanced trauma life support (ATLS).

  • Class I Hemorrhage involves up to 15% of blood volume. There is typically no change in vital signs and fluid resuscitation is not usually necessary.
  • Class II Hemorrhage involves 15–30% of total blood volume. A patient is often tachycardic (rapid heart beat) with a reduction in the difference between the systolic and diastolic blood pressures. The body attempts to compensate with peripheral vasoconstriction. Skin may start to look pale and be cool to the touch. The patient may exhibit slight changes in behavior. Volume resuscitation with crystalloids (Saline solution or Lactated Ringer's solution) is all that is typically required. Blood transfusion is not usually required.
  • Class III Hemorrhage involves loss of 30–40% of circulating blood volume. The patient's blood pressure drops, the heart rate increases, peripheral hypoperfusion (shock) with diminished capillary refill occurs, and the mental status worsens. Fluid resuscitation with crystalloid and blood transfusion are usually necessary.
  • Class IV Hemorrhage involves loss of >40% of circulating blood volume. The limit of the body's compensation is reached and aggressive resuscitation is required to prevent death.

This system is basically the same as used in the staging of hypovolemic shock.

Individuals in excellent physical and cardiovascular shape may have more effective compensatory mechanisms before experiencing cardiovascular collapse. These patients may look deceptively stable, with minimal derangements in vital signs, while having poor peripheral perfusion. Elderly patients or those with chronic medical conditions may have less tolerance to blood loss, less ability to compensate, and may take medications such as betablockers that can potentially blunt the cardiovascular response. Care must be taken in the assessment.

Massive hemorrhage

Although there is no universally accepted definition of massive hemorrhage, the following can be used to identify the condition: "(i) blood loss exceeding circulating blood volume within a 24-hour period, (ii) blood loss of 50% of circulating blood volume within a 3-hour period, (iii) blood loss exceeding 150 ml/min, or (iv) blood loss that necessitates plasma and platelet transfusion."

World Health Organization

The World Health Organization made a standardized grading scale to measure the severity of bleeding.

Grade 0 no bleeding;
Grade 1 petechial bleeding;
Grade 2 mild blood loss (clinically significant);
Grade 3 gross blood loss, requires transfusion (severe);
Grade 4 debilitating blood loss, retinal or cerebral associated with fatality

Management

Acute bleeding from an injury to the skin is often treated by the application of direct pressure. For severely injured patients, tourniquets are helpful in preventing complications of shock. Anticoagulant medications may need to be discontinued and possibly reversed in patients with clinically significant bleeding. Patients that have lost excessive amounts of blood may require a blood transfusion.

The use of cyanoacrylate glue to prevent bleeding and seal battle wounds was designed and first used in the Vietnam War. Skin glue, a medical version of "super glue", is sometimes used instead of using traditional stitches used for small wounds that need to be closed at the skin level.

Etymology

The word "Haemorrhage" (or hæmorrhage; using the æ ligature) comes from Latin haemorrhagia, from Ancient Greek αἱμορραγία (haimorrhagía, "a violent bleeding"), from αἱμορραγής (haimorrhagḗs, "bleeding violently"), from αἷμα (haîma, "blood") + -ραγία (-ragía), from ῥηγνύναι (rhēgnúnai, "to break, burst").

Emotional intelligence

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Emotional_intelligence

Emotional intelligence
(EI) is defined as the ability to perceive, use, understand, manage, and handle emotions. People with high emotional intelligence can recognize their own emotions and those of others, use emotional information to guide thinking and behavior, discern between different feelings and label them appropriately, and adjust emotions to adapt to environments.

Although the term first appeared in 1964, it gained popularity in the 1995 bestselling book Emotional Intelligence by science journalist Daniel Goleman. Goleman defined EI as the array of skills and characteristics that drive leadership performance. Some researchers suggest that emotional intelligence can be learned and strengthened, while others claim that it is an innate characteristic.

Various models have been developed to measure EI over the years. In 1987, Keith Beasley used the term Emotional Quotient (EQ) in an article, named after the Intelligence Quotient (IQ). The trait model, developed by Konstantinos V. Petrides in 2001, focuses on self reporting of behavioral dispositions and perceived abilities. The ability model (Mayeret al., 2023), 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 modelled separately as ability EI and trait EI.

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 show that there is a correlation between people with high EI and positive workplace performance, although no causal relationships have been shown. EI is typically associated with empathy because it involves a person relating their personal experiences with those of others. Since its popularization in recent decades and links to workplace performance, methods of developing EI have become sought by people 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 certain measures of EI have validity even when controlling for IQ and personality.

History

The concept of Emotional Strength was introduced by Abraham Maslow in the 1950s. The term "emotional intelligence" seems first to have appeared in a 1964 paper by Michael Beldoch, and in the 1966 paper by B. Leuner titled 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.

In 1989, Stanley Greenspan put forward a model to describe EI, followed by another by Peter Salovey and John Mayer 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 bestselling status that the term can attribute its popularity. Goleman followed up with several similar publications that reinforce use of the term.

Late in 1998, Goleman's 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 theorists' suggestions that the social, emotional, and relational competency set referred to as Emotional Intelligence is a distinguishing factor in leadership performance.

Tests measuring EI have not replaced IQ tests as a standard metric of intelligence, and Emotional Intelligence has received criticism regarding 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, distinct abilities:

  1. Perceiving
  2. Using
  3. Understanding
  4. Managing emotions

Emotional intelligence also reflects an ability to use intelligence, empathy, and emotions to enhance understanding of interpersonal dynamics. However, substantial disagreement exists regarding the definition of EI, with respect to both terminology and operationalization. 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. A person who is more emotionally responsive to crucial issues will attend to the more crucial aspects of their life. The emotional facilitation factor also involves knowing how to include or exclude emotions from thought, depending on the context and situation. This ability is related to emotional reasoning and understanding in response to the people, environment, and circumstances one encounters.

Ability model

Salovey and Mayer's strive 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 wider cognition. This ability manifests itself in certain adaptive behaviors. The model claims that EI includes four types of abilities:

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 is a basic aspect of emotional intelligence, as it makes all other processing of emotional information possible.
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.
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.
Managing emotions
the ability to regulate emotions in both ourselves and in others. The emotionally intelligent person can harness emotions, even negative ones, and manage them to achieve intended goals.

The ability EI model has been criticized 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 test 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 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 also assess ability in emotional intelligence. These include:

Diagnostic Analysis of Non-verbal Accuracy (DANVA)
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.
Japanese and Caucasian Brief Affect Recognition Test (JACBART)
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.
Situational Test of Emotional Understanding (STEU)
Test-takers complete 42 multiple-choice items assessing whether they understand which of five emotions a person would be experiencing in a given situation. There is also a brief version (STEU-B) consisting of 19 items.
Situational Test of Emotion Management (STEM)
Test-takers complete 44 multiple-choice items in which they select which of four possible responses is the most effective action to manage emotions in a specified situation. There is also a brief version (STEM-B) consisting of 18 items.

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:

  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, which 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 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 layman's 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 that 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 bestselling book.

The Trait Emotional Intelligence Questionnaire (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 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 the view that it is 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 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 offers a straightforward framework for understanding and enhancing relationships by uncovering the motivations behind people's behaviors. This theory is equally valuable for self-awareness and for improving interpersonal dynamics. Also referred to as the Five Factor Model, the Big Five Model is the most widely accepted personality theory. It suggests that personality can be distilled into five fundamental dimensions, often remembered as CANOE or OCEAN (conscientiousness, agreeableness, neuroticism, openness, extraversion). In contrast to other trait theories that sort individuals into binary categories (e.g. introvert or extrovert), the Big Five Model asserts that each personality trait exists on a spectrum. Consequently, individuals are positioned along a continuum between two contrasting poles.

General effects

A review published in the Annual Review of Psychology in 2008 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 and relationships, and negatively correlates with deviance from social norms and anti-social behavior measured both in and out of school as reported by children themselves, their own family members, and 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, with less interpersonal aggression and problems.
  3. Highly emotionally intelligent people are perceived more positively by others – Other people perceive those with high EI to be more pleasant, socially skilled, and empathic.
  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 well-being – Emotional intelligence is positively correlated with higher life satisfaction and self-esteem, and lower levels of insecurity or depression. It is also negatively correlated with poor health choices and behavior.

Emotionally intelligent people 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.

The relevance and importance of emotional intelligence in contexts of business leadership, commercial negotiation, and dispute resolution has been recognized, and professional qualifications and continuous professional development have incorporated aspects of understanding emotions and developing greater insight into emotional interactions. Especially in the globalized world, the ability to be a world leader is becoming important. A high EQ allows business leaders to interact with various different cultures, and they must be comfortable in these diverse cultural environments, having diverse teams and organization. EQ has become an essential part of leading an organization.

Interactions with other phenomena

Bullying

Bullying is an abusive social interaction between peers that 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. It also shows that emotional intelligence is a key factor in cybervictimization.

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. define 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 improve bullying prevention and intervention initiatives.

Job performance

A 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 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. 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.

Another study suggests that EI is not necessarily a universally positive trait. The study 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 be 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 study 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 letters of reference or cover letters. By 2008, 147 companies and consulting firms in the U.S. had developed programmes that involved EI for training and hiring employees. Van Rooy and Viswesvaran showed that EI correlated significantly with different domains in performance, ranging from .24 for job performance to .10 for academic performance. Employees high on EI would be more aware of their own emotions and 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. Employees high in EI show more confidence in their roles, which allow them to face demanding tasks positively.

According to a science book by the journalist Daniel Goleman, emotional intelligence accounts for more career success than IQ. 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 et al. EI contributes to developing strong and positive relationships with co-workers and to performing efficiently in work teams. This benefits performance of workers by providing emotional support and instrumental resources needed to succeed in their roles. 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. found that EI was the best predictor of job performance beyond general cognitive ability among IT scientists in a computer company in China.

When examining the connection between job performance and emotional intelligence, it's essential to take into account the impact of "managing up," which signifies a positive rapport between an employee and their supervisor. Previous research found that the quality of this relationship could influence subjective assessments of job performance. Employees with strong emotional intelligence tend to dedicate more time to cultivating their rapport with supervisors. As a result, those with higher EI are more likely to achieve favorable outcomes in performance evaluations compared to those with lower EI.

Based on theoretical and methodological approaches, EI measures are categorized in three main streams: (1) ability-based measures (e.g. MSCEIT), (2) self-reports of abilities measures (e.g. SREIT, SUEIT and WLEIS), and (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. et al. 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. Streams 2 and 3 showed an incremental validity for predicting job performance over and above personality (Five Factor model) and general cognitive ability. Both streams 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 evidence to suggest the presence of publication bias. Noting that O'Boyle Jr. et al. had included self-rated performance and academic performance in their meta-analysis, Joseph, Jin, Newman, & O'Boyle 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).

The Consortium for Research on Emotional Intelligence in Organizations argues that there is a business case in favor of emotional intelligence but, despite the validity of previous findings, some researchers still question whether EI-job performance correlation makes a real impact on business strategies. Critics argue that the popularity of EI studies is due to media advertising, rather than objective scientific findings. Also, 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, 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 suggest that emotional perception and emotional regulation components of EI highly contribute to job performance under job contexts of high emotional demands. Moon and Hur 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, the 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

Several studies attempt to study the relationship between EI and leadership. Although EI plays a positive role in leadership effectiveness, what makes a leader effective is what he/she does with his/her role, rather than his/her interpersonal skills and abilities. Although in the past a good or effective leader 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 belonging that makes employees feel comfortable, thus, making them work more effectively.

This does not mean that actions are more important than emotional intelligence. Leaders still need to grow emotionally in order to handle stress, life balance, and 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 et al. 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 in 2010 by researcher Alexandra Martins who found trait EI is 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 to conclude EI is a positive predictor for health.

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

Self-esteem and drug dependence

A 2012 study in India 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 Australia. 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.

Academic performance

A 2020 meta-analysis showed that students with higher emotional intelligence show higher academic performance at school. This was a summary of over 1,246 effects from 158 different studies, with a sample size of 42,529. Students with higher emotional intelligence had better scores on standardized tests and achieved higher grades. The effect was significantly larger for humanities than for science/maths areas of study, and significantly larger for ability emotional intelligence (measured with objective tasks), than for rating scales of emotional intelligence. The association of emotional intelligence with higher academic achievement was still significant even after considering the effect of students' Big Five personality and intelligence.

There are three reasons why greater emotional intelligence might predict stronger academic performance. First, emotionally intelligent students are able to regulate their emotions at school—they are able to control their anxiety surrounding tests and assessment, and their boredom when the material is not intrinsically interesting. This means their emotions do not impede their test scores or their ability to learn. Second, emotionally intelligent students are able to build better social relationships with other students and with instructors. This means that they have sources of help when needed—other students and teachers are more willing to help them when they get stuck. Third, some of the abilities of emotional intelligence (understanding emotions, for example) overlap with academic content, particularly in the humanities. That is, analyzing universal themes in literature or the social forces underpinning historic events require a knowledge of human emotions.

Criticisms

EI, and Goleman's original 1995 analysis, have been criticized within the scientific community:

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 that "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.

It is difficult to create objective measures of emotional intelligence and demonstrate its influence on leadership as many scales are self-report measures.

In a 2009 academic exchange, Antonakis and Ashkanasy/Dasborough mostly agreed that researchers who test 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: it found that, 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 also support this 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. A study analyzing the impact of EI on both job performance and leadership found that the meta-analytic validity estimates for EI dropped to zero when Big Five traits and IQ were controlled for. A meta-analysis showed the same result for Ability EI.

Self-reported and Trait EI measures retain a fair amount of predictive validity for job performance after controlling Big Five traits and IQ. However the greater predictive validity of Trait EI measures can be attributed 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.

A study of the predictive ability of EI for job performance concluded that higher EI was associated with higher leadership effectiveness regarding achievement of organizational goals. This study shows that EI may serve an identifying tool in understanding who is (or is not) likely to deal effectively with colleagues. Furthermore, one can develop and enhance one's leadership qualities by advancing one's emotional intelligence. EI can be deliberately developed, specifically the facets of "facilitating thinking with emotions" and "monitoring and regulation of emotions" in the workplace.

Correlations with personality

Researchers raised concerns about the extent to which self-report EI measures correlate with established personality dimensions. Self-report EI measures and personality measures converge because they both purport to measure personality traits. Two dimensions of the Big Five stand out as most related to self-report EI: neuroticism and extraversion. Neuroticism relates to negative emotionality and anxiety. People who score high on neuroticism are likely to score low on self-report EI measures.

Studies examined the multivariate effects of personality and intelligence on EI and attempted to correct estimates for measurement error. For example, one study showed that general intelligence (measured with the Wonderlic Personnel Test), agreeableness (measured by the NEO-PI), as well as gender could reliably predict the measure of EI ability. They gave a multiple correlation (R) of .81 with the MSCEIT (perfect prediction would be 1). This result was replicated. The replication 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).

A study of 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 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."

A 2017 meta-analysis of 142 data sources found a very large overlap between the general factor of personality and trait EI. The overlap was so large they concluded that "The findings suggest that the general factor of personality is very similar, perhaps even synonymous, to trait EI." However, the overlap between the general factor of personality and ability EI was more moderate, with a correlation of about 0.28.

In 2021, two review papers examined the relationship between emotional intelligence and the dark triad of personality traits (narcissism, Machiavellianism, and psychopathy). This research found that emotional intelligence showed negative associations with all three dark triad domains of personality. Of the four ability branches of emotional intelligence, the largest effects were for emotion management (versus emotion perception, use, or understanding) and for psychopathy (versus narcissism or Machiavellianism). The two different facets of narcissism showed different relationships with emotional intelligence. Vulnerable narcissism (characterized by anxiety and fragile self-esteem) was associated with lower emotional intelligence. However, grandiose narcissism (characterized by self-confidence, dominance, and an inflated sense of ego) related to higher levels of emotional intelligence. This indicates that not all "dark" personalities lack emotional intelligence.

A 2021 meta-analysis showed that emotional intelligence was positively associated with secure attachment in adults, but negatively associated with insecure attachment styles such as anxious attachment and avoidant attachment. The associations with anxious attachment and avoidant attachment were significant for both ability EI and for rating scales of EI. However, only rating scales of EI showed a significantly positive association with secure attachment. The authors suggest that the early development of attachment styles may facilitate (or hinder) the development of emotional abilities and traits involved in EI.

Socially desirable responding

Socially desirable responding (SDR), or "faking good", is a response pattern in which test-takers systematically represent themselves with an excessive positive bias. This bias has long been known to contaminate responses on personality inventories, acting as a mediator of the relationships between self-report measures.

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

There is evidence that people can ‘‘fake good’’ on emotional intelligence tests, resulting in inaccurate measurement with several studies showing people can distort their responses on both self-rated and informant-rated emotional intelligence measures when instructed to.

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. 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 that EI is a type of intelligence or cognitive ability. Eysenck 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 claims that the concept of EI is 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 these criticisms 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. 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 that 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

Another criticism says that in contrast with 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". If someone knows how they should behave in an emotionally laden situation, it does not necessarily follow that they could actually carry out the reported behavior.

NICHD pushes for consensus

The National Institute of Child Health and Human Development recognized that because there are divisions about the topic of EI, 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...".

Operator (computer programming)

From Wikipedia, the free encyclopedia https://en.wikipedia.org/wiki/Operator_(computer_programmin...