Expressed emotion and interdependence in White and Latino/Hispanic family members of patients with schizophrenia

Abstract

This study examined associations among ethnicity, expressed emotion (EE) and interdependence in a sample of 41 Latino/Hispanic and White family members of patients with schizophrenia. EE was assessed using both the Camberwell Family Interview (CFI) and the Five Minute Speech sample (FMSS). These measures were found to be highly concordant for rating EE. However, the CFI appears to identify high EE more often than does the FMSS. Whites were designated as high EE significantly more often than were Latinos/Hispanics, regardless of assessment method. Using the interdependence subscale of the Self Construal Scale, we found a strong trend for Latino/Hispanics to report a more interdependent self-construal than did Whites. However, contrary to expectations, interdependence was not found to mediate the relationship between ethnicity and EE. EE and interdependence may both play a role in the better course of illness observed for patients from traditional cultures. However, these two constructs may relate to patient functioning through different mechanisms.

Shame and guilt/self-blame as predictors of expressed emotion in family members of patients with schizophrenia

“…While the FMSS is easy to administer, predicts clinical outcome in schizophrenia (Marom et al, 2002, 2005), and correlates with the Camberwell Family Interview ( CFI ; Magaña et al, 1986; Weisman de Mamani et al, 2007), it appears to be less sensitive than the CFI in the detection of high EE (Hooley and Parker, 2006). With large samples this issue may be less salient.…”

Expressed emotion and sociocultural moderation in the course of schizophrenia.

“…Both studies had the limitation of using only three time points that may have reduced their ability to detect relationships. Additionally, Wuerker et al (2002) measured EE using the Five Minute Speech Sample (FMSS), which underestimates the presence of high EE (Weisman de Mamani et al, 2007) and has limited predictive validity (Hooley, 2007). Altogether, past attempts to assess the relationship between EE and later symptomatology have yielded largely negative findings.…”

“…What is deemed stressful may depend on the sociocultural context (Kymalainen & Weisman de Mamani, 2007; Weisman de Mamani, Kymalainen, Rosales, & Armesto, 2007). Research on expressed emotion across different national and ethnic groups suggests that the sociocultural context may influence the family's emotional climate and levels of EE (Bhugra & McKenzie, 2003).…”

Expressed Emotion and Health Outcomes Among Mexican-Americans With Schizophrenia and Their Caregiving Relatives

“…Given the significant obstacles faced by MexicanAmericans in accessing mental health services (Vega and López, 2001) and the importance of strong family ties within many Mexican-American families (Raeff et al, 2000), families may play an especially large role in the care and treatment of Mexican Americans with serious mental illness. Although the presence of strong familial support within many Latino families has been hypothesized to be a protective factor for individuals with schizophrenia (Weisman de Mamani et al, 2007), research suggests that the provision of care for a relative with a chronic illness may exert a physical and psychological toll on caregivers themselves (Grant, 1999;Winefield and Harvey, 1993). Consequently, providing care and support to an ill relative may be associated with differential health outcomes for caregivers as compared to their ill relatives.…”