SummaryPatterns of interaction and attitudes in the relationships of 21 young schizophrenic patients, their parents and therapists were explored and compared with each other in this pilot study. The focus was on expressed emotion (EE), which was revealed to have an important impact on the course of the illness. In this study, the EE status of the relatives as well as of the therapists was rated using the five-minute speech sample method. Furthermore, data on the quality of interaction of therapists and parents with the patients were derived from the therapist/relative-patient interaction scale. Results showed that one-third of both the therapists and the parents were rated high on EE. High-EE relatives were rejected and perceived as inscrutable by the patients. The assessment of the therapeutic and familial relationships demonstrated the patients’ need for unequivocal communication. Differences and similarities in the interaction styles, and their implications for research and therapy are discussed.
SummarySchizophrenic patients seem to react sensitively to expressed affect. Expressed emotion research has shown the negative impact of specific family communication styles on the course of illness. Further studies have discussed its relation to gender. This study examines the dyadic aspects of the therapist-patient relationship, the interaction between therapist's ratings and patient's psychopathology, and the predictive value concerning the course of illness. Results show a significant association with gender. Male therapists were inclined to reduce their therapeutic commitment when being confronted with patients who suffered from disturbances Of ego-function, attention, or perception. Female therapists felt rejected by patients with delusions and with formal thought disorders, but perceived themselves as competent when dealing with anergic patients. Furthermore, patients with a less favorable course of illness at the 2-year follow-up could be discriminated by the quality of the therapist-patient relationship at the end of the primary therapeutic intervention.
In an explorative study, a clinical sample of 53 schizophrenic patients was examined. The EMBU inventory was used for measuring perceived parental rearing practices, the AfS for rating the quality of relationship to key relatives and the U-Scale for assessing social anxiety. The findings obtained were intercorrelated and compared with 3 selected parameters of disease severity: age at first hospitalization, number of treated episodes and length of hospital stay. The results suggest that the quality of contact with key relatives is determined to a larger extent by the schizophrenia than by parental rearing attitudes. Rearing behaviour more likely influences the age at first hospitalization and social anxiety, whereas considering the length of face-to-face contact, the quality of the relationships between patients and their key relatives can be assumed to be associated with the duration of hospital stays.
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