Perception Of Expressed Emotion Research Articles

Perceived expressed emotion in individuals with a first episode of psychosis from a south Asian background.

To explore perceived expressed emotion in the south Asian context for individuals with a first episode of psychosis (FEP). Semi-structured interviews were conducted with 16 service users experiencing a FEP to understand their experience of expressed emotion (EE) from their caregivers. Interviews were analysed using inductive thematic analysis. Four main categories were identified: connection and support, understanding and awareness, boundaries and independence and context and influence. Factors influencing perceived expressed emotion such as acceptance, acculturation, warmth and expressions of love, communication and family values were identified. Findings highlight south Asian's experiences of being cared for, and their perception of EE, including warmth and connection as a strength and resource. The findings shed light on culturally specific EE within the context of FEP that can be considered when working with south Asian communities within early interventionservices. Findings highlight the impact of navigating and negotiating bicultural identities and generational differences in EE in the British south Asian context.

Service User Perceived Criticism and Warmth (SU-PCaW) Questionnaire

ABSTRACT Background The outcomes for a wide range of physical and mental health conditions can be influenced by the level of criticism and warmth in the family environment known in the literature as Expressed Emotion (EE). This finding is also true for individuals with an At-Risk Mental State (ARMS) for psychosis with individual’s perceptions of EE predicting transition to psychosis. While the original concept of EE incorporates both positive and negative aspects of relationships, most measures of EE and research focus on the negative aspects of relationships. Positive factors are also important and associated with improvements in functioning and reduced symptoms. However, the absence of a comprehensive, self-report measure of positive aspects of EE has hindered research in this area. Methods This study aimed to investigate the reliability and validity of a new 10-item Service User Perceived Criticism and Warmth Questionnaire (SU-PCaW) based on the 2-item Perceived Criticism and 2-item Perceived Warmth questionnaires. Results The measure was quick and easy to administer and had high internal consistency and reliability. Conclusion This measure would aid services in screening families for therapy, be helpful in evaluating family intervention in groups such as the ARMS population and a useful measure for future research developments.

The impact of familial expressed emotion on clinical and personal recovery among patients with psychiatric disorders: The mediating roles of self-stigma content and process.

The present study examined the associations of familial expressed emotion (EE) with clinical and personal recovery among patients with psychiatric disorders, as well as the potential mechanisms underlying these associations. Guided by the content-process theory of self-stigma, we hypothesized that EE would be negatively associated with clinical and personal recovery and that these associations would be mediated by self-stigma content and process. A total of 311 patients with psychiatric disorders completed questionnaires on their perceptions of EE, self-stigma, and recovery. Structural equation modeling demonstrated that EE was positively associated with self-stigma content and process, which were in turn negatively associated with clinical and personal recovery. The indirect effects of EE on clinical and personal recovery, via self-stigma content and process, were also significant. Multigroup analyses further demonstrated that the impact of EE on self-stigma and recovery was generalizable across patients with psychotic and nonpsychotic disorders. Theoretically, our findings revealed the potential pathways through which EE may adversely affect psychiatric recovery. Practically, our findings highlighted the importance of designing multipronged intervention programs to reduce familial EE and its potential harmful impact on psychiatric patients. In addition to helping family members improve their knowledge about psychiatric disorders and adjust their communication styles, practitioners should help psychiatric patients develop resilience against EE, mitigate self-stigma, and achieve recovery. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychiatric social work intervention program for “high expressed emotion” among the caregivers of persons with schizophrenia in India – a feasibility study

Introduction Schizophrenia is a severe mental illness that creates various psychosocial problems among family members. In addition, the family also contributes to psychosocial issues such as, expressed emotion. Expressed emotion (EE) has been found to predict relapse. Literature indicated that psychosocial interventions along with medicines would helps in mainstreaming the persons with illness. However, there is paucity of culturally sensitive interventions for EE in India. Methodology The objective of the study is to test the feasibility of cultural sensitive psychiatric social work intervention package to reduce expressed emotion among the caregivers of persons with schizophrenia in India. Ten caregivers of inpatients with schizophrenia from National Institute of Mental Health and Neurosciences, India, participated in the study. MINI 6.0 was used as screening tool. Socio-demographic profile collected. The Family Emotional Involvement and Criticism Scale was used to elicit the expressed emotion. A standardized 10 session spread over 10 days psychiatric social work package was given to the caregivers. Intervention package included methods of Social work and various techniques. Results and conclusion Mean score of family income (M=3200, SD=1.98), onset of illness (M=26.0, SD=6.56), illness duration (M=3.10, SD=1.41), duration of care giving (M=2.3, SD=1.56). Overall ill individual's perception of expressed emotion on their caregivers was found to be decreased in post-assessment (M=29.60, SD=2.9) when compared to the pre-assessment (M=50.0, SD=1.9). It was found to be statistically significant (0.000*= P

Mother and adolescent expressed emotion and adolescent internalizing and externalizing symptom development: a six-year longitudinal study.

In expressed emotion (EE) theory, it is held that high EE household environments enhance adolescent psychopathological distress. However, no longitudinal study has been conducted to examine if either the mother’s EE or the adolescent’s perception of EE predicts adolescent internalizing and externalizing symptom dimensions (an EE effect model) or vice versa (psychopathological effect model) together in one model. To unravel the reciprocal influences of maternal and adolescent perceived EE to adolescent internalizing and externalizing symptom dimensions, we tested two (i.e., one for internalizing and one for externalizing) cross-lagged panel models. In this study, it was found that both internalizing and externalizing symptom dimensions predicted the adolescent’s perception of maternal EE as well as the mother’s own rated EE criticism over time. The findings of this study should give both researchers and therapists a reason to reevaluate only using the EE effects model assumption in future EE studies.

Dyadic view of expressed emotion, stress, and eating disorder psychopathology

Prevailing models of the association between expressed emotion (EE) and relapse conceptualize EE as a form of stress for patients. In eating disorders (ED), there is no research addressed to evaluate the degree to which patients feel stress due to their relatives’ EE. It has been neither investigated how the EE and the subsequent stress relate to disordered behaviours and attitudes neither. Using a sample of 77 inpatients with ED, this study aimed to: (1) evaluate patients’ reported level of stress as it relates to their caregivers’ EE, particularly as associated with carer's criticism, emotional overinvolvement and warmth; (2) examine the associations of stress with the patients’ perceptions (self-reported) and the caregivers’ perspective (assessed by the Camberwell Family Interview) of the EE; and (3) study how the two views of EE (patients’ and caregivers’) and the stress due to EE relate to the ED symptoms. The findings indicate that patients judged their carers’ critical stance as the most stressful, followed by emotional overinvolvement. Secondly, patients’ perceptions of EE, whereas none of the interview indices focused on the caregivers’ perspective, were associated to the stress and to the ED symptomatology. Additionally, the patients’ stress due to criticism was positively related to the ED symptoms, while the stress associated with emotional overinvolvement and warmth was not. Clinical and research implications are discussed. Findings suggest attention to the ED patients’ view of their family environment and support the utility of assessing their appraisals of EE.

The effects of EE on the long term course of schizophrenic illness—results of an 8 years follow-up

Prevailing models of the association between expressed emotion (EE) and relapse conceptualize EE as a form of stress for patients. In eating disorders (ED), there is no research addressed to evaluate the degree to which patients feel stress due to their relatives’ EE. It has been neither investigated how the EE and the subsequent stress relate to disordered behaviours and attitudes neither. Using a sample of 77 inpatients with ED, this study aimed to: (1) evaluate patients’ reported level of stress as it relates to their caregivers’ EE, particularly as associated with carer's criticism, emotional overinvolvement and warmth; (2) examine the associations of stress with the patients’ perceptions (self-reported) and the caregivers’ perspective (assessed by the Camberwell Family Interview) of the EE; and (3) study how the two views of EE (patients’ and caregivers’) and the stress due to EE relate to the ED symptoms. The findings indicate that patients judged their carers’ critical stance as the most stressful, followed by emotional overinvolvement. Secondly, patients’ perceptions of EE, whereas none of the interview indices focused on the caregivers’ perspective, were associated to the stress and to the ED symptomatology. Additionally, the patients’ stress due to criticism was positively related to the ED symptoms, while the stress associated with emotional overinvolvement and warmth was not. Clinical and research implications are discussed. Findings suggest attention to the ED patients’ view of their family environment and support the utility of assessing their appraisals of EE.

Relatives' expressed emotion (EE) vs. patients' perceptions of EE: Which is a better predictor of course?

Relatives' expressed emotion (EE) vs. patients' perceptions of EE: Which is a better predictor of course?