Abstract
We examined expressed emotion (EE) and attributions in parents with schizophrenia and compared them to parents without serious mental illness (SMI) in order to better understand the emotional climate of families in which a parent has schizophrenia. Parenting practices and parental reports of child behavior were also compared between the two groups. The relationship of EE to attributions was examined in each group separately. Relationships between parental mental health, EE, and attributions were explored in the parents with schizophrenia only. The Camberwell Family Interview was used to determine both EE and attributions in 20 parents with schizophrenia and 20 parents without SMI. We found that more parents with schizophrenia were rated as high EE than those without (60 and 35%, respectively) although this was not a statistically significant difference. Parents with schizophrenia demonstrated significantly more hostility and criticism toward their children than those without SMI and made more child-blaming attributions. Blame was associated with increased hostility, less warmth, and fewer positive remarks. Parental warmth was related to greater parenting self-efficacy, less harsh parenting practices, better child behavior, and a more positive parent–child relationship. We conclude that EE and attributions are potential explanatory variables to be considered in the development of preventative and early intervention strategies for families with a parent with schizophrenia or other psychotic disorder. Blame and warmth are modifiable factors that could be targeted within family and parenting interventions.
Highlights
Schizophrenia is a chronic and severe illness, with a high global disease burden and significant economic cost [1]
Multiple linear regression was used to determine the relative impact of parental mental health status on expressed emotion (EE) and attributions compared to demographic variables
The finding that parents with schizophrenia were more critical and hostile about their children is an important one, since parental EE has been linked to the development and maintenance of a range of childhood disorders [25] and to mental health difficulties and substance misuse problems in adulthood [28]
Summary
Schizophrenia is a chronic and severe illness, with a high global disease burden and significant economic cost [1]. It is plausible that EE may be a potential mechanism of intergenerational transmission in schizophrenia, no research has sought to determine EE in parents living with schizophrenia This is surprising since parents with mental illness are more likely to have been raised in a family environment characterized by high EE themselves [22]. Criticism, has been associated with the development and maintenance of a range of childhood disorders in families without parental mental illness [25] including increased behavioral problems in individuals with autism [26, 27]. Relationships between parental mental health, parenting practices, attributions, and EE were explored in the parents with schizophrenia in order to ascertain whether mental health was associated with facets of EE or attributions and whether EE and attributions had a directly impact on parenting practices
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