Post-stroke emotionalism: A qualitative investigation

Niamh McAleese, Azucena Guzman, Suzanne O'Rourke, David C. Gillespie

Research output: Contribution to journalArticlepeer-review


Introduction: Post-stroke emotionalism, outbursts of involuntary crying or laughing, is common after stroke. Little is known about the psychosocial factors associated with this neurological disorder.

Aim: To investigate participant’s experiences of emotionalism and explore how they managed their symptoms.

Methods: A qualitative study that used framework analysis. Participants were recruited across inpatient and outpatient stroke settings. The average time since stroke was 4.3 months.

Results: Eighteen semi-structured interviews were conducted. Four themes were identified: (1) Spontaneous and uncontrollable emotional reactions; (2) Incongruence; (3) Social reactions (sub-theme: The stigma of expressed emotions) and (4) Convalescence. Participants with negative experiences described greater disability, avoidance and mood problems. Positive experiences were shaped by a better understanding of the condition, an increased sense of control, social support and optimism. Few participants knew that their emotionalism was caused by stroke. Embarrassment and social withdrawal were commonly reported and had a detrimental effect on participant’s mood and quality of life.

Conclusions: Earlier recognition of emotionalism in clinical settings is needed as is promoting discussions about emotional reactions after-stroke. This will reduce the likelihood that patients will develop erroneous beliefs about emotionalism and unhelpful coping responses that may lead to adjustment difficulties in the months that follow their stroke.

Implications for rehabilitation

The unpredictable and uncontrollable nature of emotionalism can be embarrassing and cause social withdrawal or avoidance.

Waiting for emotionalism episodes to pass, distraction, humor or optimism and social support are successful means of managing the condition.

Professionals play a key role in raising awareness that emotionalism is a neurological condition and not a clinical mood disorder as this will promote better understanding for patients, their families and those around them.

Encouraging patients to talk about their emotional reactions early after stroke will normalize their experiences and may prevent them from developing unhelpful beliefs that could affect their approach to recovery.
Original languageEnglish
Pages (from-to)192-200
Number of pages10
JournalDisability and rehabilitation
Issue number2
Early online date28 May 2019
Publication statusPublished - 16 Jan 2021


  • stroke
  • crying
  • laughter
  • emotionalism
  • adaptation
  • psychological


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