Expressed emotion, family dynamics and symptom severity in a predictive model of social adjustment for schizophrenic young adults

Abstract

While numerous studies have concluded that high expressed emotion (EE) in relatives predicts relapse in schizophrenia, other aspects of patient outcome have not been well studied. Our purpose was to determine the extent to which family dynamics and expressed emotion may predict variance in patient social adjustment when controlling for symptom severity. Sixty-nine schizophrenic outpatients and 108 of their relatives participated. Relatives' EE was assessed, and they were administered the FACES III for perceptions of family cohesion and adaptability. Patients were interviewed at about the same time as their relatives and again 9 months later with the Social Adjustment Scale (SAS-II) and the BPRS. Between 9% and 58% of variance in each of the five SAS scales was explained by selected EE and family dynamics scales, while symptom severity was held constant. Among the results, it was found that better social adjustment in patients was associated with less family adaptability, and with greater emotional overinvolvement in relatives. Adjustment of patients in the work role was associated with more Critical Comments from mothers. In conclusion, some aspects of high EE are associated with better social adjustment in schizophrenic patients.