Families Of Psychiatric Patients Research Articles

Understanding the Dynamics: A Comprehensive Review of Family Therapy's Impact on Expressed Emotions in Schizophrenia Patients.

This comprehensive review examines the impact of family therapy on expressed emotions (EE) within the context of psychiatric disorders. EE, characterized by high levels of criticism, hostility, or emotional over-involvement, have been consistently linked to poorer treatment outcomes and increased severity of psychiatric symptoms. The review explores various family therapy approaches and their effectiveness in reducing high EE levels in families of psychiatric patients. It synthesizes existing literature to highlight the mechanisms underlying the changes in EE, such as modifying communication patterns and enhancing family cohesion. Additionally, the review discusses the implications for clinical practice, emphasizing the importance of integrating family therapy into psychiatric treatment plans and providing psychoeducation to empower families to manage emotions effectively. Future research directions are also outlined, including investigating the long-term sustainability of changes brought about by family therapy and exploring cultural considerations in therapeutic approaches. Overall, the review underscores the pivotal role of family therapy in addressing EE and promoting recovery and resilience in psychiatric patients and their families.

Evaluation Of The Overload Of Care In Families Of Psychiatric Patients In Psychosocial Care Center

Introduction: The burden of care in family refers to the weight caused by the primary caregiver role to psychiatric patients and the difficulties encountered in performing this function in daily life.
 Objectives: Assessing the objective and subjective overload of family members who live with the reality of psychiatric disorder in a child day-care psychosocial care center. Methods: Cross-sectional study, descriptive-exploratory, of quantitative approach, with non-probabilistic samples of accidental type with 80 families of psychiatric patients held in a Psychosocial Care Center. For overload evaluation, the subscales "B" and "D" of the Family Overload Rating Scale (FBIS-BR) were used.
 Results: The study was conducted with 80 families of psychiatric patients. The average age of female caregivers was 39,6 years old, and 40,7 years old for male caregivers, with female predominance (87,5%) compared to men (12,5%), with low education for both genres. Family caregivers presented high objective burden due to excessive demand attention (p<0,001), heteroaggressiveness (p<0,001) and perplexing behavior of psychiatric patients regarding the supervision of problematic behaviors (p<0,001). The items on the impact on the family's daily routine have not helped to generate objective overload for the family members. On subjective overload, it was clear to observe familiar members with high degree of disturbance in all the dimensions assessed (p < 0,001).
 Conclusion: The high degree of care overload observed in family members indicates the need to develop contacts with the family of the psychiatric patient to answer questions, offer support and assistance to the family caregiver.
 Keywords: Caregivers. Patients. Mental Health Services.

Families of Chronic Psychiatric Patients

This study aims to investigate the studies conducted with the families of chronic psychiatric patients in Turkey and determine the characteristics and scope of future studies. In order to map out the recent studies conducted with the families of psychiatric patients in Turkey national and international databases were reviewed and eventually 26 studies were found to be suitable for inclusion. Of 26 studies reviewed, 7 studies were experimental and 19 studies were designed as descriptive in which certain reference points were defined such as mental health conditions of the family, family burden, quality of life, functionality, expressed emotions and their needs for education. On the other hand, the experimental studies mostly focused on the effects of various psychoeducation intervention programs particularly designed for care givers on patients and families. It was concluded that there is an obvious insufficiency in the number studies and researches on defining stress management levels and burdens of the families of chronic psychiatric patients as well as intervention programs specially designed for such families. Particularly designed invervention programs and studies are warranted.

396 – Family functioning in the families of psychiatric patients: comparison of psychotic and non psychotic families

Introduction Family functioning is one of the most important factors in psychiatric treatment. The purpose of this study was to compare the family functioning between patients with psychotic and non psychotic disorders in Shahrekord, Iran. Method and materials This analytical discriptive study was performed on family members of 200 patients with schizophrenia(psychotic), mood and anxiety disorders(nonpsychotic). The data was collected through interview by using the family assessment device (FAD). Quantative analysis of data was undertaken by using T students. Findings The mean of the total score of FAD in family members of psychotic and nonpsychotic patients was 2.55 ± .31 and 2.34 ± .25 respectively, and FAD in non psychotic patients was significantly better than psychotic patients in all dimensions of FAD. Discussion The present study highlights that the family functioning among caregivers of patients with Psychotic and non psychotic disorders were unhealthy in all of the domains of the family functioning.

It Takes a Family

It Takes a Family

Application of nurse-patient communication in the families of psychiatric patients and the effect assessment

Objective To explore the implementation of the families of psychiatric patients with nurse-patient communication methods to improve patient compliance,harmonious doctor-patient relationship,reduce medical disputes.Methods According to hospital in different periods,individual or collective discussion forum,telephone,computer,goin to patients families and so on methods were taken.Results Patients compliance were increased,hospitalization time was shortened and medical disputes were reduced.Conclusion Implementation of nurse-patient communication on the families of psychiatric patients with can improve the compliance behaviors,reduce patient disputes,reduce the relapse rate. Key words: Nurse-patient communication; The families of psychiatric patients

More Fundamentally Human than Otherwise

Beal and her colleagues are to be commended, and congratulated, for venturing forth in exploring the everyday experiences of people with serious mental illnesses as they go about meeting the challenges of establishing lives for themselves in the community following extended inpatient care. As community integration increasingly becomes the goal of community mental health services, the relatively uncharted territory of how people with severe and persistent mental illness navigate their immediate social environments becomes both a timely and important focus for empirical study. The contribution of Beal and her colleagues advances a growing body of research in this area describing various processes involved in the person’s efforts to manage his or her psychiatric condition as he or she goes about trying to reclaim his or her life. In addition to those references cited in Beal et al.’s paper, this body of research includes work by Barham (1992, and with Hayward, 1998), Corin (1990, 1998, and with Lauzon, 1992, 1994), Davidson and colleagues (1992, 1995, 1997, 2001, 2001, 2003; Sells, 2004), Estroff (1989, 1994, 1995a, 1995b), Lovell (1997), Ridgway (2001), and others. I would like, briefly, to consider the specific contribution of Beal and her colleagues within this broader context. Several of the findings of this study are noteworthy. First, the investigators note that people with schizophrenia need to “venture forth” into the world in order to “connect” to others, even though at times these others may be virtual or delusional in nature. Second, they describe ways in which environmental factors, activities, objects, and past experiences may be used to facilitate these processes of venturing forth and connecting, as well as some ways in which they might impede these processes. Finally, they recognize that the processes they have identified and described in the lives of people with schizophrenia being discharged from long–term inpatient care “should be seen as relatively normal ones and as part of the struggle we all face in living in the world together.” In other words, people with schizophrenia appear to engage in the same strategies for navigating community life that the rest of us (i.e., those of us who do not have schizophrenia) engage in when we find ourselves in similar circumstances (e.g., being newly relocated or visiting a foreign country for the first time). Although the investigators present their findings in this order, we would like to reverse their order of consideration in Psychiatry 68(3) Fall 2005 243

Families of psychiatric patients: A critical review and future research directions

It is generally acknowledged that mental illness creates burdens for family caregivers. Since the 1950s, medical literature has identified the type and extent of those burdens, especially for families of patients with schizophrenia. Whereas the imperative to identify interventions for these families is clear, there has been a lack of systematic research of families' responses to and management of mental illness, resulting in significant gaps in knowledge. The rapidly changing health-care environment suggests that our understanding of families' responses to mental illness need to be reexamined for current relevance and new insights. This article critically examines the research to date and identifies gaps in knowledge related to family experience of mental illness. It argues the need to continue studies of caregiver burden and the stress resulting from that burden. Future directions for research are suggested.

Cross-national validity of dimensions of family functioning: First experiences with the Dutch version of the McMaster Family Assessment Device (FAD)

The present study describes the first psychometric findings obtained in The Netherlands with the Dutch version of the Family Assessment Device (FAD) which was originally developed in the Anglo-American cultural context. In a sample of community volunteers, confirmatory analysis (multiple-group method) provided evidence of factorial validity of the FAD measuring constructs. Only 3 out of 60 items were found to be biased and had to be deleted from their a priori defined scales. Reliability and homogeneity indices pertaining to each FAD dimension were good. Despite (very) high correlations among FAD factors/scales, further analyses were focused on determining their convergent and divergent validity which offered good support for such. A higher-order analysis which incorporated reliable scales of the FAD and the Family Environment Scale yielded a two-factor composition: General Family Functioning and Family Influence / Power and Integration. There was evidence to support the viewpoint that a general measure of family functioning may be utilized which is broader in terms of content than the already existing subscale measure termed General Functioning. In line with findings pointing to the ability of the FAD to distinguish between families of psychiatric patients and nonclinical families, the great majority of the FAD subscales, especially Problem Solving and General Functioning, were found to correlate with psychological symptom states as assessed with the Symptom Checklist-90-R. Specific subscales were found to be affected by educational level, while none were affected by sex, age, or religious affiliation. All in all, the findings confirm the further use of the FAD in the Dutch national context.

The Training of Social Work Students in the Psychoeducation Model of Family Treatment

The purpose of this paper is to describe a training program in the psychoeducational model of fanmily treatment for graduate social work students who have their practicum in the psychiatric division of a large urban medical center. The training program was designed to enhance students' clinical skills with the families of psychiatric patients through the introduction of pscyhoeducational content. Students also were able to utilize this interventive approach in their actual field cases.

Introduction to the special series.

Although the assessment and treatment of marital and family disorders from a psychological perspective have been conducted in one form or another for the past 40 years, the progression toward a view of these disorders as involving both intrapersonal as well interpersonal and broader systemic factors has been an arduous and uneven one. Early theoretical views of marital dysfunction in the 1940s were primarily intrapersonal in nature, with relationship distress seen as the culmination of unresolved conflicts; intrapersonal dysfunction was viewed as both a necessary and sufficient source of interpersonal distress. The promulgation of family systems views in the 1950s and 1960s reflected at least in part a rejection of narrow psychodynamic formulations and drew attention both to socioecological factors in individuals' personal and relationship functioning and to nonlinear, reciprocal patterns of influence. Although systemic formulations were intuitively appealing on a conceptual level, they presented difficulty in generating specific, operationalized predictions. Consequently, a strong impetus existed for the development of marital and family treatment programs from a behavioral or social-learning perspective in the late 1960s and 1970s. Unfortunately, although they offered both theory driven and testable predictions regarding relationship functioning, early sociallearning models suffered from a naive exclusion of intrapersonal or cognitive mediators of interpersonal exchange. The rapprochement of intrapersonal and interpersonal models has been confined primarily to the last decade, drawing heavily on research from other subdisciplines within psychology on attention, attribution, expectancies, and subjective values. Despite the absence of a dominant, coherent theoretical model, both clinical practice and research in marital and family therapy have demonstrated exponential growth in the last two decades, as reflected by an increase in scholarly journals devoted to this area, by both the number and size of professional associations representing marital and family practitioners and researchers, and (as recently as 1985) by the designation of family psychology as a separate division within the American Psychological Association. To what should such growth be attributed? Traditionally, explanations have emphasized the high incidence of marital dissolution or the prevalence of marital and other family concerns in those individuals who seek mental health services. More recently, attention has turned to the role of marital and family dynamics not only in psychological difficulties in children or domestic violence but also in such individual disorders as depression, schizophrenia, and substance abuse. The series begins with three articles examining the role of marital and family dysfunction in more traditional psychiatric disorders. Jacobson, Holtzworth-Munroe, and Schmaling review both theoretical models and empirical data relating marital therapy to the treatment of depression, agoraphobia, and alcoholism. Hahlweg et al. examine previous research on expressed emotion in families of psychiatric patients and on relapse following hospitalization to present data relating interactional patterns in the families of schizophrenics to expressed emotion in patients' relatives; both base-rate and sequential analyses demonstrate strong effects of negative interactions and suggest the potential utility of family interaction patterns as indicators of relapse proneness. Alexander, Waldron, Barton, and Mas examine the effects of relabeling and of positive versus negative interactions in altering attributions in families of delinquent adolescents; their results suggest that initial, negative exchanges in these highly conflicted families may generate negative artributional schemata highly resistant to clinical intervention. Kazak extends the conceptual framework beyond emotional or behavioral disorders in arguing for the importance of a systems and social-ecological perspective in serving families of chronically ill children. Three articles examine considerations in marital therapy from both conceptual and empirical perspectives. Baucom, Epstein, Sayers, and Sher discuss the role of cognitions in marital This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the user and is not to be disseminated broadly.

Family functioning in the families of psychiatric patients

The functioning of families of five psychiatric groups and a group of nonclinical families was assessed by the Family Assessment Device (FAD), a recently developed multidimensional measure of family functioning. The results indicated that families of patients with major depression, alcohol dependence, and adjustment disorder reported greater family dysfunction than nonclinical families. Families of schizophrenic and bipolar patients did not differ significantly from controls.

Assessment of drugs in schizophrenia. Assessment of psychiatric and social state. 20V

British Journal of Clinical PharmacologyVolume 3, Issue S2 p. 385-390 Free Access Assessment of drugs in schizophrenia. Assessment of psychiatric and social state. 20V DB Scott, DB ScottSearch for more papers by this authorFP Buckley, FP BuckleySearch for more papers by this authorGB Drummond, GB DrummondSearch for more papers by this authorDG Littlewoods, DG LittlewoodsSearch for more papers by this authorWR Macrae, WR MacraeSearch for more papers by this author DB Scott, DB ScottSearch for more papers by this authorFP Buckley, FP BuckleySearch for more papers by this authorGB Drummond, GB DrummondSearch for more papers by this authorDG Littlewoods, DG LittlewoodsSearch for more papers by this authorWR Macrae, WR MacraeSearch for more papers by this author First published: June 1976 https://doi.org/10.1111/j.1365-2125.1976.tb03730.xCitations: 10AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References Birley, J.L.T. & Brown, G.W. (1970). Crises and life changes preceding the onset or relapse of schizophrenia. Br. J. Psychiat., 116, 327– 333. Brown, G.W. & Birley, J.L.T. (1968). Crises and life changes and the onset of schizophrenia. Hlth. soc. Behav., 9, 203– 214. Brown, G.W., Birley, J.L.T. & Wing, J.K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. Br. J. Psychiat., 121, 241– 258. Brown, G.W. & Rutter, M.L. (1966). The measurement of family activities and relationships. Hum. Relat., 19, 241– 263. Cooper, J.E. et al. (1972). Psychiatric Diagnosis in New York and London. Maudsley Monograph No. 20. London: Oxford University. Dencker, S.J., Frankenberg, K., Malm, U. & Zell, B. (1973). A controlled one-year study of pipothiazine palmitate and fluphenazine decanoate in chronic schizophrenic syndromes. Acta psychiat. scand., suppl., 241, 101– 118. Hirsch, S.R., Gaind, R., Rohde, P.D., Stevens, B.C. & Wing, J.K. (1973). Out-patient maintenance of chronic schizophrenic patients with long-acting fluphenazine: a double-blind placebo trial. Br. med. J., 1, 633– 637. Leff, J.P., Hirsch, S.R., Gaind, R., Rohde, P.D. & Stevens, B.C. (1973). Life-events and maintenance therapy in schizophrenic relapse. Br. J. Psychiat., 123, 659– 660. Leff, J.P. & Vaughn, C. (1972). Psychiatric patients in contact and out of contact with services. In Evaluating a Community Psychiatric Service, ed. J.K. Wing & A. Hailey London: Oxford University. Leff, J.P. & Wing, J.K. (1971). Trial of maintenance therapy in schizophrenia. Br. med. J., 3, 599– 604. Maxwell, A.E. (1972). Difficulties in a dimensional description of symptomatology. Br. J. Psychiat., 121, 19– 26. Sillitoe, K.K. (1969). Planning for Leisure. Government Social Survey. London: HMSO. Vaughn, C. & Leff, J.P. (in press). The measurement of expressed emotion in families of psychiatric patients. Br. J. soc. clin. Psychol.. Wing, J.K., Cooper, J.E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University. World Health Organization (1973). The International Pilot Study of Schizophrenia, 1. Geneva: WHO. Citing Literature Volume3, IssueS2June 1976Pages 385-390 ReferencesRelatedInformation

The measurement of expressed emotion in the families of psychiatric patients.

In a series of studies of the influence of family life on the course of an established schizophrenic illness, it has been shown that the level of emotion expressed by relatives shortly after a schizophrenic patient is admitted to hospital is strongly associated with symptomatic relapse during the nine months following discharge (Brown et al., 1962, 1972). This paper states the case for an abbreviated version of the primary research instrument used in these studies, the Camberwell Family Interview Schedule. In the 1972 study the single most important measure contributing to the overall expressed emotion index proved to be the number of critical remarks made about the patient by the relative when interviewed alone. An analysis of 15 tape-recorded interviews from this study showed that the majority of critical comments were produced within the first hour and there was virtually no relationship between total number of critical comments and length of interview (r = 0.08). This analysis supported the use of a shortened interview in which the areas most likely to produce any criticism were given priority in the sequence of questioning. This abbreviated version has been used successfully in a replication and extension of the 1972 study. A group of 37 schizophrenic patients is being compared with a group of 31 depressed neurotic patients. Patterns of emotional response of these patients' relatives are discussed.

Experiment With Abnormal Families

CLINICIANS who treat whole families report that the identified patient's Psychopathology is a product of the kind of family in which he lives. A major goal in family research has been to find evidence for or against the idea that families of psychiatric patients are different from average families which do not contain such patients. Methods of investigating this question have included interviewing family members, observing families in the home, bringing families to the laboratory for raters to observe conversations, and taking measurements of family behavior in experimental contexts. The latter approach was used in the study reported here. Samples of families with a diagnosed patient or a family problem were contrasted with control groups of average families in a restricted communication network while discussing two different kinds of conversational stimuli. Few differences were found between the two groups. The problem of determining