Abstract
BackgroundRelapse is increased in people with psychosis who live with carers with high expressed emotion (EE). Attributional style has been used to understand EE at a psychological level. Previous studies have investigated carer appraisals for negative events in the patient's life. We therefore aimed to examine spontaneous carer attributions for both negative and positive events. Further, we distinguished between high EE based on critical comments, and that based on emotional-overinvolvement. MethodAudiotapes of the Camberwell Family Interview (CFI) (N = 70) were rated using the Leeds Attributional Coding System (LACS). Raters were blind to previous ratings of EE. ResultsIn our sample, low EE carers made significantly more attributions about positive events, and less about negative events than high EE carers. This is because criticism, but not overinvolvement, was strongly associated with responsibility attributions for negative events, while overinvolvement, but not criticism, was inversely associated with responsibility attributions for positive events. ConclusionCarers' attributions for both positive and negative events may be a useful target for improving family interventions in psychosis.
Highlights
Expressed emotionExpressed Emotion (EE) is a construct originally measured by rating how carers talk about the person they care for during a semi-structured interview, the Camberwell Family Interview (CFI) (Brown & Rutter, 1966; Vaughn & Leff, 1976)
3 carers were given a hostility rating, and hostility was never rated in the absence of criticism, so it was dropped from further analysis
Carer criticism related to patient anxiety, and not to patient depression. These results suggested that low expressed emotion (EE) carers make proportionately more responsibility attributions for positive than negative
Summary
Expressed emotionExpressed Emotion (EE) is a construct originally measured by rating how carers talk about the person they care for during a semi-structured interview, the Camberwell Family Interview (CFI) (Brown & Rutter, 1966; Vaughn & Leff, 1976). EE is of value because the risk of relapse of psychotic illness is greater in those whose carers display a high level of criticism, hostility or emotional-overinvolvement (EOI). These are termed high EE carers (Bebbington & Kuipers, 1994; Butzlaff & Hooley, 1998). We aimed to examine spontaneous carer attributions for both negative and positive events. Results: In our sample, low EE carers made significantly more attributions about positive events, and less about negative events than high EE carers. Conclusion: Carers’ attributions for both positive and negative events may be a useful target for improving family interventions in psychosis
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