EMOTIONAL Presenters: Dr.

Prabhmeet Singh
INTELLIGENCE AND Dr. Supriya
CLINICAL DECISION Coordinator: Dr. Vivek Srivastav
MAKING Chairperson: Dr. Aparna Goyal
 Flow of seminar
1. Emotions
2. Neurobiology of emotions
3. History of emotional intelligence
4. Definition of emotional Intelligence
5. Models of emotional Intelligence
6. Emotional intelligence tests
7. Clinical decision-making
8. Conclusion
EMOTIONS
A complex reaction pattern,
Involving experiential, behavioral, and physiological elements,
By which individual attempts to deal with a personally significant matter or
event.
The specific quality of the emotion (e.g., fear, shame) determined by the specific
significance of the event. 

American Psychiatric Association (APA 2018)

Neurobiology of emotions

Antonio, Colombo, Monteverde, Martins, Fernandes, Bauchiglioni et al; (2017)

The right hemisphere might be dominant for automatic components of
the emotional response (such as experience, expression, and autonomic
activation).
The left hemisphere is specialized for functions of control and
modulation of the spontaneous emotional response.
Gainotti G. 1983.
Robert Plutchik (1980) constructed a wheel-like diagram of emotions
visualising eight basic emotions, plus eight derivative emotions each
composed of two basic ones.
BASIC HUMAN
EMOTIONS

Anger, disgust, fear, happiness, sadness, and surprise

Paul Ekman
INTELLIGENCE
A very general mental capability that, among other things, involves the
ability to reason, plan, solve problems, think abstractly, comprehend
complex ideas, learn quickly and learn from experience.
It is not merely book learning, a narrow academic skill, or test-taking
smarts.
It reflects a broader and deeper capability for comprehending our
surroundings"catching on," "making sense" of things, or "figuring out"
what to do.

Gottfredson, Linda S (1997)

EI: DEFINITION

The processes involved in the recognition, use, understanding and

management of one’s own and others’ emotional states to solve emotional-
laden problems and to regulate behavior.
(Mayer and Salovey 1997)
EI: DEFINITIONS
A set of non-cognitive skills, abilities, competencies and capabilities that
allow individuals to cope with environmental pressures.

(Bar-On 1997)

The means to perceive and express emotions and regulate emotions in

self and others.

Kasman D et al. (2003)

 Brief history of emotional intelligence
•1930s - Edward Thorndike -the concept of "social intelligence" as the ability
to get along with other people.
•1940s - David Wechsler- suggests that affective components of intelligence
may be essential to success in life.
•1950s - Humanistic psychologists such as Abraham Maslow describe how
people can build emotional strength.
•1975 - Howard Gardner published The Shattered Mind, which introduced the
concept of multiple intelligences.
1985 - Wayne Payne introduced the term emotional intelligence in his
doctoral dissertation entitled "A study of emotion: developing emotional
intelligence; self-integration; relating to fear, pain and desire.
1987 - In an article published by, Keith Beasley used the term "emotional
quotient.
1990 - Psychologists Peter Salovey and John Mayer published their
landmark article, "Emotional Intelligence," in the journal Imagination,
Cognition, and Personality.
1995 - The concept of emotional intelligence got popularized after publication
of psychologist and New York Times science writer Daniel Goleman's
book Emotional Intelligence: Why It Can Matter More Than IQ.
IQ
 Your emotional quotient
generally refers to your ability

EQ to sense emotion in yourself

and in other people. It also
refers to how you use that
awareness to guide your
behavior. In general, if you
have a high EQ, you may find
resolve conflicts with it easier to: identify emotions in
others yourself and others

withstand
empathize with other
temptations and
people
delay gratification

adapt your feelings

control your impulses and behavior to
different situations
KEY DIFFERENCES BETWEEN
IQ AND EQ
1. IQ refers to the analytical, mathematical and logical reasoning capabilities
of a person. EQ measures his personal skills and power to use to emotions.
2. EQ can be improved upon and learned, however , IQ is something you are
born with
3. EQ is more relevant to success and happiness in life, IQ determines
whether you have the innate abilities for it.
4. IQ decides your individual capacities and intelligence, EQ decides whether
you are a team player or how well you will respond to a crisis.

Daniel Goleman, 2006

 Your IQ is what determines your
competencies and individual
capacities, but your EQ determines
how you interact and treat people in
your life, it shows how you are
going to cope with pressures or face
the crisis.

The difference between these two is

that no one can alter his/her
intelligence or reasoning abilities,
but anyone can learn to handle
emotions, to bring success for him.
THREE MAIN MODELS OF
EMOTIONAL INTELLIGENCE

Mixed
Trait Model
Ability Model
Model
ABILITY MODEL
Perceiving emotions

Reasoning with
Emotions
This model was developed by
Peter Salovey and John Mayer Understanding
Emotions

Managing Emotions
PERCEIVING EMOTIONS:

Ability to identify emotion in one’s physical and psychological states.

Ability to identify emotion in other people.

Ability to express emotions accurately and to express needs related to

them.

Ability to discriminate between accurate and inaccurate feelings.

REASONING WITH EMOTIONS:

Ability to redirect and prioritize thinking on the basis of associated

feelings.

Ability to generate emotions to facilitate judgement and memory

Ability to capitalize on mood changes to appreciate multiple points of

view.

Ability to use emotional states to facilitate problem solving and

creativity.
UNDERSTANDING EMOTIONS:

Ability to understand relationship among various emotions.

Ability to perceive the causes and consequences of emotions.

Ability to understand complex feelings, emotional blends, and

contradictory states.

Ability to understand transitions among emotions.

EMOTIONAL MANAGEMENT:

Ability to be open to feelings, both pleasant and unpleasant.

Ability to monitor and reflect on emotions

Ability to engage, prolong, or detach from an emotional
state.
Ability to manage emotions in oneself.

Ability to manage emotions in others.

GOLEMAN’S MODEL OF
COMPETENCIES FOCUSED ON THE
WORKPLACE

(Goleman, Daniel.
2000)
SELF-AWARENESS

This is the ability to recognize and understand one's moods, motivations, and
abilities. Also understanding the effects, they have on others.  
Example: By reading the reaction of someone else, you know
how you are perceived by them.
SELF-REGULATION

This is the ability to control one’s impulses, the ability to think before you
speak/react, and the ability to express yourself appropriately.

Example: If someone is screaming at you, you know that they are not always
angry at you. You have the ability to understand they may be angry at a
particular situation and feel they need to take it out on someone. You do not
take this personally and do not react back in anger.
MOTIVATION

Pursue goals energetically with a passion beyond the need for monetary gain
or status recognition

Example: If a student fails a class, they see this as an opportunity to learn

and retake the class without self doubt. They do not let failure get in the way
of their goal.
EMPATHY

This is the ability to understand other people emotions and reactions

Sensitivity towards the emotional state, concerns, and viewpoint of others.

Example: Being able to understand cope with someone else's hardships or

sadness. When you fully understand yourself and why you feel the things
you feel, you can understand other people even if they are different than
you.
SOCIAL SKILLS

Identify, analyze, and manage relationships with people inside and outside of your
team.
Ability to communicate, persuade and lead others while being direct and honest
without alienating people.

Example: Someone in a "boss" position usually has a good grasp on handling all
different types of personalities. If two of their employees are having a conflict,
they can find common ground and resolve the issue in a civilized and fair manner.
 Bar-on’s social-emotional intelligence
model of inter-related emotional and personality traits -well established
Cross-section
and interact together in the individual.

Intrapersonal Interpersonal Adaptability

skills skills

1.SelfRegard, 1. Empathy
2.Emotional Self 2.Social 1.Reality-Testing,
Awareness Responsibility 2.Flexibility
3.Assertiveness, 3. Interpersonal 3.Problem-Solving;
4.Independence, Relationship
5.Self-Actualization
 Stress management General Mood

• Stress Tolerance • Optimism

• Impulse Control • happiness
TRAIT MODEL
•Trait model is defined as "a constellation of emotional self-perceptions
located at the lower levels of personality.”

It includes:
•Ones understanding and perception of their emotions.
•The use of personality framework to investigate trait emotional intelligence.

Marks a break from the idea that emotional intelligence is ability-based.

Instead, it proposes that people have, as part of their personalities, a number of
emotional self-perceptions and emotional traits.

(Petrides et al; 2009)

TESTS FOR EI
1 Bar-On's Emotional Quotient Inventory (EQ-i): 
2 Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT):
An ability-based test that measures the four branches of Mayer and
Salovey's EI model.
3 Emotional and Social Competence Inventory (ESCI): 
Involves having people who know the individual offer ratings of that
person’s abilities in several different emotional competencies.
4 Trait Emotional Intelligence Questionnaire (TEIQ)
THE MAYER-SALOVEY-CARUSO
EMOTIONAL INTELLIGENCE TEST
(MSCEIT)
•MSCEIT was developed from an intelligence-testing tradition formed by
the emerging scientific understanding of emotions and their function and
from the first published ability measure specifically intended to assess
emotional intelligence, namely Multifactor Emotional Intelligence Scale
(MEIS).
•MSCEIT consists of 141 items
•Takes 30-45 minutes to complete

(Mayer, Salovey et al; 2002)

EMOTIONAL AND SOCIAL
COMPETENCE INVENTORY (ESCI)
Uses of ESCI
EMOTIONAL AND SOCIAL
COMPETENCE INVENTORY (ESCI)
Kaur j et al 2019
BENEFITS OF EI
•It gives the ability to identify others
emotional expressions.
•It makes people more satisfied with their
interpersonal relationships.
•It makes a person able to manage their
moods.
•It makes a person more adaptable when
under stress.
•It is an attribute of good leaders and
team-workers.
•It is Positively associated with
psychological well-being.
Clinical decision making and
EI
CLINICAL DECISION MAKING -
DEFINITION
• Process of determining what to do by
professionals in healthcare setting.

(Thompson and Dowding, 2009)

• Reasoning to choose between various options.

(Eysenck, 2013; Goldstein, 2011)

Ellis et al 2020
(a) recognition and clarification of a problem
(b) identification of potential solutions
(c) appraisal of potential solutions
(d) selection of course of action
(e) implementation of the chosen course of action
(f) evaluation of the solution adopted

Entwistle et al.2006
Lerner et al 2015
MODELS OF CLINICAL
DECISION MAKING
The
information-
processing
model

The cognitive The intuitive-

continuum humanist
model model
Banning - information-processing model of decision making with its decision
trees as assuming a logical, rational processing of facts to reach a decision,
and the intuitive-humanist model as evolving pattern recognition from novice
to expert.
Stages -cue recognition
hypothesis generation
cue interpretation
hypothesis evaluation

Banning M et al 2007
• Hammond’s-- cognitive continuum theory
strategies from ‘analytical’ to ‘intuitive’ employed according to
the nature of the task recognizes the fluid nature of the decision-
making process.

• Intuitive-humanistic model-
Intuition making or sensing of
•physical connection(focus on body language and non-verbal communication
patterns
•spiritual connection (abstract and involve the exchange of energy fields)

Smith et al 2004
Two main themes in the context of emotions in clinical decision making:
• subjective experience of emotion-emotional response to contextual
pressures
emotional responses to others
intentional exclusion of emotion

• application of emotion and cognition in decision making

compassionate emotional labor- responsiveness to patient

interdisciplinary tension regarding the significance and

meaning of emotion emotional and moral judgement.
Kozlowski D ,Hutchinson M, Hurley J, Sutherland J 2017
EIGHT MAJOR THEMES –
EMOTIONAL IMPACT ON
JUDGEMENT AND
1. Integral emotions influence decision making DECISION

MAKING
o Emotion that strongly shapes the decision making (Greene and Haidt 2002)
o Example - a person who feels anxious about the potential outcome of a risky choice may
choose a safer option rather than a potentially more lucrative option

2. Incidental emotions influence decision making

o Incidental emotions pervasively carry over from one situation to the next, affecting
decisions that should, from a normative perspective, be unrelated
to that emotion (Keltler and Lerner 2010)
o Example- incidental anger triggered in one situation automatically elicits a
motive to blame individuals in other situations
3. Beyond valence: Specific emotions influence decision making
o Emotions of the same valence (anger and sadness) - associated with different
antecedent appraisals, depths of processing, brain hemispheric activation, facial
expressions, autonomic responses and central nervous system activity

(Ekman 2007)
o To increase the predictive power and precision of emotions-
Appraisal-Tendency Framework (ATF) - systematically links the appraisal
processes associated with specific emotions to different judgment and choice outcomes
Lerner and Keltner (2000, 2001)

4. Emotions shape decisions via the content of thought

o Appraisal-Tendency Framework - identifies the effects of specific emotions on
judgment and choice- by breaking down emotions into cognitive dimensions that can be
mapped onto the content of thought and decision making (Lerner 2000)
5. Emotions shape the depth of thought
o Emotions also influence the depth of information processing related to decision making
(Lerner et al 2002)
6. Emotions shape decisions via goal activation
o Emotions serve an adaptive coordination role- triggering a set of
responses (physiology, behavior, experience, and communication) that enable individuals
to deal quickly with encountered problems or opportunities

(Keltner et al 2014)

7. Emotions influence interpersonal decision making

o Emotions as communication systems- help people navigate and coordinate social
interactions - providing information about others’ motives and dispositions- creation and
maintenance of healthy and productive social relationships
8. Unwanted effects of emotion on decision making can only sometimes be
reduced
To minimize the deleterious effects of emotions on decision making -

Minimizing Insulating decision

magnitude of process from
emotional response emotions
• Time delay • Crowding out
• Reappraisal emotion
• Using • Increasing
counteracting awareness to
emotions misattribution
Neuroimaging indicated that higher emotional intelligence correlated with
increased activation in the rostral anterior cingulate cortex --involved in
executive function such as decision making, error detection, empathy, and
control of impulsivity

Kilgore et al.,(2013)

functional magnetic resonance imaging (fMRI) revealed the interaction

of the orbitofrontal cortex (ORC) between decision-making and processing
emotion

coricelli et al 2005
Initially, clinical decision making has been perceived as a
purely rational and cognitive process. Number of authors
have linked emotional intelligence (EI) to clinical decision
making (CDM) and calls have been made for an increased
focus on EI skills for clinicians.

Research confirms emotions constitute a potent and

pervasive driver of judgment and decision- making
processes. It is recognized that emotions influence risky
decisions, reduce cognitive fixation, and enhance attention.

(Kozlowski, Hutchinson;2017)
Emotional contexts of decision making includes the need to manage stress and
anxiety emerging from uncertainty

Participants said their reluctance to make decisions stemmed from their conviction
that causing harm by omitting treatment was somehow superior to causing harm by
offering the wrong treatment.

Tallentire Med Educ 2011;45(10):995-1005

Clinicians largely aimed to separate emotion from clinical decision making
40% agreed that other clinicians experienced a negative effect on their
clinical decisions as a result of emotions
Only 21.1% thought the same applied to themselves

Lafrance Robinsone et al Eat Disord. 2015;23(2):163-76

PHYSIOLOGICAL EVIDENCE
OF EMOTIONAL
INVOLVEMENT IN DECISION
MAKING
empirical evidence has been
found linking ‘intuitive decision
making’ with galvanic skin
response, a physiological
indicator of autonomic arousal
commonly associated with
emotional state.
In a study on nursing staff -found that
nurses demonstrating significantly
more sympathetic activation while
performing decision tasks in simulated
medical emergency scenarios also
performed better on the decision task.
these results could be thought of as
objective evidence of the use of
intuition in nursing.
(Payne LK, J Nurs Educ. 2013)
EMPIRICAL STUDIES ON CDM
AND EI
• De Jesus (2006) identified emotional intelligence helps to formulate a
personalized decision.
• Beauvais et al. (2011) indicated emotional intelligence is correlated with
nursing performance.
• Ashoorion et al. (2012) showed the medical students’ ability of clinical
decision making is predicted by emotional intelligence, which can explain
46% of variance.
• Emotional intelligence --important to make effective decisions in day-to-day
life of leader in an organization.

• Strong emotions help leaders to make effective decisions.

• Decisions - cognitive and emotional components.

• A decision maker’s emotional processing ability depends on-

previous experience,
current emotional capital or capacity
emotional investment an individual is willing to make in the decision’s
outcome.
(Zaki, Abd-Elrhaman,
Ghoneimy;2018)
CONCLUSION
 Knowledge and skills are more valuable when possessed by people
who can apply them in emotionally sensitive ways.
 Emotions influence how health professional learners identify and
perceive information, and interpret and act on it.
 Emotional influence should be integrated into clinical decision -
making
process.
 Emotions constitute powerful and predictable drivers of decision making.
Across different types of decisions, important regularities appear in the
underlying mechanisms through which emotions influence judgment and choice.

 Emotions may influence decisions through multiple mechanisms, via changes

in (a) content of thought, (b) depth of thought, and (c) content of implicit
goals.
Theories that generate predictions for specific emotions appear to provide
more comprehensive accounts of decision-making outcomes than do theories
that generate predictions for positive versus negative moods.

 When emotional influences are unwanted, it is difficult to reduce their

effects
through effort alone. The field of emotion and decision making is growing at
an accelerating rate but is far from mature.
 THANK
YOU