Expressed and Perceived Criticism, Family Warmth, and Symptoms in Schizophrenia

2013 ◽  
Vol 16 ◽  
Author(s):  
Cristina Medina-Pradas ◽  
J. Blas Navarro ◽  
Esther Pousa ◽  
M. Isabel Montero ◽  
Jordi E. Obiols
Keyword(s):  
Expressed Emotion ◽  
Psychotic Symptoms ◽  
Emotional Involvement ◽  
Positive Attitudes ◽  
Subjective Assessments ◽  
The Family ◽  
Family Interview ◽  
Perceived Criticism ◽  
Family Warmth ◽  
Patients Perspective

AbstractCriticism directed by caregivers towards a family member with schizophrenia, both from the perspective of the patient and of the caregiver, predicts relapse, although both perspectives differ. This study aims to verify if the same applies to a Mediterranean sample, where criticism is not the main attitude of high expressed emotion families. The Camberwell Family Interview was applied to assess the family’s perspective, and the Perceived Criticism and the Family Emotional Involvement and Criticism Scales were used to assess the patients’ perspective, in 21 dyads. The association between both perspectives and psychotic symptoms was also examined. Results replicated those of previous studies in other countries, revealing that the perspectives on Criticism of patients and families do not match. The fact that family members also presented positive attitudes towards the patient did not cushion the patient’s perceived criticism. Thus, it seems that families considered to be critical may not be perceived as such by the patients. Furthermore, only the warmth from the family’s perspective correlated with the symptoms: positive affect proved to be more relevant than negative affect. Therefore, the patients’ subjective assessments and family warmth should be included in clinical and research proposals.

Expressed Emotion in the Client-Professional Dyad

2004 ◽  
Vol 20 (4) ◽  
pp. 237-246 ◽  
Author(s):  
G. Van Humbeeck ◽  
Ch. Van Audenhove ◽  
G. Storms ◽  
M. De Hert ◽  
G. Pieters ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Correlation Matrix ◽  
Concurrent Validity ◽  
Positive Relationship ◽  
Expressed Emotion ◽  
Family Interview ◽  
Insufficient Time ◽  
Perceived Criticism

Summary: Background: This article reports on a study of the concurrent validity between the standard expressed emotion instrument, the Camberwell Family Interview (CFI), and two alternative EE measures, the Level of Expressed Emotion (LEE) and the Perceived Criticism Scale (PCS). Methods: The research sample consisted of 56 schizophrenic clients, who were residing in sheltered residences, and 56 professionals. Results: Based on the results of the correlation matrix between all the subscales of the instruments, a significantly positive relationship was found between the criticism scale of the CFI, the total score of the LEE, and the client version of the PCS. These correlations, however, were rather weak, which implies that the three instruments have little in common with each other. The professionals' version of the PCS does not appear to be an EE instrument. Conclusions: The results suggest that the CFI still remains the best instrument for assessing EE in a therapeutic relationship (between a professional and a client). If there is insufficient time to administer the CFI, then the client version of the PCS and the LEE can be used with the qualification that the PCS and LEE also measure other aspects and thus cannot completely replace the CFI. Nevertheless, the research indicates that asking the clients would seem to provide a better indication of the level of the professionals' criticism rather than asking the professionals themselves directly.

The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion

2002 ◽  
Vol 33 (1) ◽  
pp. 91-96 ◽  
Author(s):  
W. SELLWOOD ◽  
N. TARRIER ◽  
J. QUINN ◽  
C. BARROWCLOUGH
Keyword(s):  
Social Functioning ◽  
Expressed Emotion ◽  
Family Intervention ◽  
Psychotic Symptoms ◽  
Number Of Factors ◽  
The Family ◽  
Two Factors ◽  
The Subject ◽  
The Relationship

Background. A variety of factors are related to compliance with medication in schizophrenia, but little attention has been paid to the role of families. Carers' knowledge or expressed emotion (EE) may be related to compliance. The aim of the present study was to evaluate the relevance of these two factors, as well as their relationships with other variables for the prediction of compliance.Method. A sample of patient–carer pairs (N=79) involved in a family intervention for schizophrenia trial was recruited. Compliance, symptoms, social functioning and attitudes to their carers were assessed in patients. Carers' EE, knowledge and psychopathology were also evaluated.Results. A number of factors were related to compliance, including carers' EE and patients' psychotic symptoms, which contributed independently to not taking medication. Carers' knowledge about schizophrenia and other groups of symptoms was not related to compliance.Conclusions. EE may be an important factor to account for in the understanding of patients' compliance and the direction of the relationship between EE and compliance should be the subject of further study.

Compare “family atmosphere” in informal caregivers of patients with psychotic symptoms compared to their inclusion or not in self-help associations

2017 ◽  
Vol 41 (S1) ◽  
pp. S381-S381
Author(s):  
M. Mentis ◽  
M. Gouva ◽  
E. Kotrsotsiou ◽  
N.V. Angelopoulos ◽  
E. Dardiotis
Keyword(s):  
Family Environment ◽  
Expressed Emotion ◽  
Informal Caregivers ◽  
Psychotic Symptoms ◽  
Family Environment Scale ◽  
Self Help ◽  
Environment Scale ◽  
The Family ◽  
Competing Interest ◽  
Self Help Groups

IntroductionThe participation of informal caregivers in the café of patients with psychotic symptoms in coordination with self-help groups have been found to reduce the expressed emotion in combination with psychoeducations interventions help create a supportive environment.ObjectivesThis study investigates the differences in the family atmosphere of informal caregivers of patients with psychotic symptoms.AimsTo compare whether or not the participation of informal caregivers of patients with psychotic symptoms in self-organized associations helps to foster a supportive family environment, hence reducing the risk of relapse.MethodsSnowballing sampling consisting of 510 informal caregivers of patients with psychotic symptoms was used in the current study. The Family Environment Scale of Moos and Moos and socio-demographic questions were implemented to collect the data. Control Cronbach's Alpha reliability of scale gave value a = 0.795.ResultsThe comparison showed that informal caregivers of patients with psychotic symptoms irrespective of their participation or not in self-help associations do not show significant differences in Family Environment Scale. Significant statistical difference between the two groups (P < 0.05) only occurred in the subcategory “organization”, as the first group (m = 4.68, df = ± 2.233) were found to have lower values compared to the other group (m = 5.21, df = ± 2.233).DiscussionsThe study demonstrated that informal caregivers of patients with psychotic symptoms involved in self-help groups do not show to have a particular difference in the family atmosphere than families who do not participate in self-help associations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A study of expressed emotion, perceived stress and socio-demographic profile in patients of dissociative disorder

2020 ◽  
Vol 8 (8) ◽  
pp. 2861
Author(s):  
Nitesh Kumar Singh ◽  
Pankaj Gupta ◽  
Jai Singh Yadav
Keyword(s):  
Perceived Stress ◽  
Expressed Emotion ◽  
Rating Scale ◽  
Primary Diagnosis ◽  
Stressful Event ◽  
Dissociative Disorder ◽  
Subjective Response ◽  
Emotional Involvement ◽  
Cross Sectional ◽  
Perceived Criticism

Background: Dissociation is understood as one of coping mechanism to deal with intense stressors. Individuals vary widely in their subjective response to a similar stressful event depending on number of factors including their family and social support system. So, authors tried to study the expressed emotion in patients of dissociative disorder along with other socio-demographic factors and its relation with perceived stress.Methods: This cross-sectional descriptive study was done on 100 patients with primary diagnosis of dissociative disorder. Hamilton depression rating scale (HAM-D) was used to assess comorbid Depressive symptoms and Hamilton anxiety rating scale (HAM-A) was used to asses comorbid anxiety symptoms. Perceived stress scale (PSS) was used to assess the perception of stress. Family emotional involvement and criticism scale (FEICS) was used to measure perceived criticism (PC) and intensity of emotional involvement (EI).Results: Mean perceived stress in this study was 25.8. Mean score for perceived criticism (PC) was 16.5 and emotional involvement (EI) was 15.7. Both measures of expressed emotions were significantly higher in females and subjects belonging to joint families and rural area. In this study perceived stress by subjects was significantly (p=0.001) correlated to perceived criticism (Pearson r = 0.78) and emotional involvement (Pearson r = 0.77).Conclusions: High perceived criticism and emotion over involvement of family member was associated with perceived stress in dissociation patients.

Confirmatory Factor Analysis of the Family Emotional Involvement and Criticism Scale: Evidence of the Dimensionality of Expressed Emotion

2003 ◽  
Vol 92 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Stephen M. Gavazzi ◽  
Patrick C. McKenry ◽  
Jill A. Jacobson ◽  
Teresa W. Julian ◽  
Brenda Lohman
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Expressed Emotion ◽  
Factor Model ◽  
Family Members ◽  
Married Couples ◽  
Emotional Involvement ◽  
Convenience Sample ◽  
Confirmatory Factor ◽  
The Family

Using a convenience sample of 152 married couples, the present study tested models that alternately considered family members' perceptions of Expressed Emotion to be a one-, two-, three-, or four-factor construct as measured by the Family Emotional Involvement and Criticism Scale. Results of confirmatory factor analysis procedures indicated that perceptions of Expressed Emotion were best represented by a four-factor model that consisted of involvement, criticism, upset feelings, and approval. The methodological implications of these findings are discussed.

scholarly journals Stigma and expressed emotion: a study of people with schizophrenia and their family members in China

2002 ◽  
Vol 181 (6) ◽  
pp. 488-493 ◽  
Author(s):  
Michael R. Phillips ◽  
Veronica Pearson ◽  
Feifei Li ◽  
Minjie Xu ◽  
Lawrence Yang
Keyword(s):  
Expressed Emotion ◽  
Family Members ◽  
Cognitive Responses ◽  
Highly Educated ◽  
Standard Work ◽  
Severe Effect ◽  
The Family ◽  
Family Interview ◽  
High Level ◽  
Work Up

BackgroundThe most damaging effect of stigma is the internalisation of others' negative valuations.AimsTo explore the factors that mediate patients' emotional and cognitive responses to stigma.MethodBased on responses to 10 open-ended questions about stigma appended to the Chinese version of the Camberwell Family Interview, trained coders rated the effect of stigma on both patients and family members in 1491 interviews conducted with 952 family members of 608 patients with schizophrenia at 5 sites around China from 1990 to 2000.ResultsFamily members reported that stigma had had a moderate to severe effect on the lives of patients over the previous 3 months in 60% of the interviews, and on the lives of other family members in 26% of the interviews. The effect of stigma on patients and family members was significantly greater if the respondent had a high level of expressed emotion, if the patient had more severe positive symptoms, if the respondent was highly educated and if the family lived in a highly urbanised area.ConclusionsClinicians should assess the effect of stigma as part of the standard work-up for patients with mental illness, and help patients and family members reduce the effect of stigma on their lives.

The shaping of individuals’ mental structures and dispositions by others

2005 ◽  
Vol 6 (1) ◽  
pp. 131-144 ◽  
Author(s):  
Kurt Hahlweg
Keyword(s):  
Mental Disorders ◽  
Mood Disorders ◽  
Hospital Discharge ◽  
Family Environment ◽  
Expressed Emotion ◽  
Future Studies ◽  
The Family ◽  
Emotional Overinvolvement ◽  
History Of ◽  
Family Interview

Expressed emotion (EE) is a measure of the family environment that has been demonstrated to be a reliable, cross-culturally valid psychosocial predictor of relapse in patients with schizophrenia, mood disorders, and other — also somatic — illnesses. Assessed during the Camberwell Family Interview CFI, relatives are classified as being high in EE if they make more than a specified threshold number of critical comments or show any signs of hostility or marked emotional overinvolvement. In schizophrenia, the median relapse rate for patients returning after hospital discharge to a high EE environment is 48%, compared with 21% in a low EE-environment. In this article, the history of EE research will be outlined, and the evidence for the association between family EE and the course of schizophrenia and mood disorders will be presented. Conclusions about the treatment of major mental disorders are discussed as well as the directions of future studies.

Family perspectives on organ and tissue donation for transplantation: A principlist analysis

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Sao Paulo ◽  
Tissue Donation ◽  
São Paulo ◽  
Ethical Considerations ◽  
Donation Process ◽  
The Family ◽  
Organ Procurement Organizations ◽  
Family Interview

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

Family-focused Behavioral Pediatrics: Clinical Techniques for Primary Care

1995 ◽  
Vol 16 (12) ◽  
pp. 448-455
Author(s):  
William L. Coleman ◽  
Barbara J. Howard
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Family Intervention ◽  
Symptomatic Patient ◽  
Psychosocial Problem ◽  
Behavioral Pediatrics ◽  
The Family ◽  
Family Interview

Whenever a behavioral or psychosocial problem presents in a child, all members of the family are affected. Conversely, when the problem lies within the family, the child is affected and often presents as the symptomatic patient. The goals of family-focused pediatrics are to: 1) determine the need for a family intervention; 2) conduct a family interview-assessment; 3) clarify the issues; 4) teach healthy communication skills and interactions; and 5) facilitate generation of family goals and solutions. Family-focused strategies provide an effective, brief, and timely approach that can aid the pediatrician in helping children and their families function in more healthy and satisfying ways.

scholarly journals The Role of the Family in the Course and Treatment of Bipolar Disorder

2007 ◽  
Vol 16 (4) ◽  
pp. 192-196 ◽  
Author(s):  
David J. Miklowitz
Keyword(s):  
Bipolar Disorder ◽  
Expressed Emotion ◽  
Psychosocial Interventions ◽  
Developmental Pathways ◽  
Psychosocial Stressors ◽  
At Risk Children ◽  
The Family ◽  
Initial Onset ◽  
Patterns Of Interaction

Bipolar disorder is a highly recurrent and debilitating illness. Research has implicated the role of psychosocial stressors, including high expressed-emotion (EE) attitudes among family members, in the relapse–remission course of the disorder. This article explores the developmental pathways by which EE attitudes originate and predict relapses of bipolar disorder. Levels of EE are correlated with the illness attributions of caregivers and bidirectional patterns of interaction between caregivers and patients during the postepisode period. Although the primary treatments for bipolar disorder are pharmacological, adjunctive psychosocial interventions have additive effects in relapse prevention. Randomized controlled trials demonstrate that the combination of family-focused therapy (FFT) and pharmacotherapy delays relapses and reduces symptom severity among patients followed over the course of 1 to 2 years. The effectiveness of FFT in delaying recurrences among adolescents with bipolar disorder and in delaying the initial onset of the illness among at-risk children is currently being investigated.

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