Expressed emotion (EE) in families of individuals at-risk of developing psychosis: A systematic review

Izon, Emma; Berry, Katherine; Law, Heather; French, Paul

doi:10.1016/j.psychres.2018.10.065

Cited by 26 publications

(28 citation statements)

References 34 publications

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“…There is limited research with relatives of individuals with ARMS. Izon, Berry, Law, Au-Yeung, and French's (2019) Considering the recommended interventions and early service involvement for at-risk individuals, we might expect reduction in worry, improvements in family member well-being, and similar outcomes to families of FEP individuals. That is assuming all individuals have access to the same standard of treatment, with family members feeling supported.…”

Section: Carers Of Individuals Experiencing Psychosis Have Increased mentioning

confidence: 99%

“…The current study aimed to understand the different types of changes, similarities, and reflections of those family/carers 12 months after taking part in the original qualitative interviews (Izon et al, 2019). This study is the first of its kind to use a qualitative longitudinal methodology to capture the nuances and outcomes of supporting someone at ARMS over 12 months.…”

Section: Carers Of Individuals Experiencing Psychosis Have Increased mentioning

confidence: 99%

“…Stage 1 involved utilizing the thematic framework from the 14 interviews coded into themes and subthemes at baseline (Izon et al, 2019). The themes and subthemes were revisited for each participant to ensure that they accounted for the 10 who took part in the second interview and not exclusively for the four who did not.…”

Section: Stagementioning

confidence: 99%

“…Coding was both based on the prior publication themes and subthemes (Izon et al, 2019) but also grounded from the 12-month data (see Table 2). A mixed method approach was adopted.…”

Section: Stagementioning

confidence: 99%

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“I don't think I took her fears seriously”: Exploring the experiences of family members of individuals at‐risk of developing psychosis over 12 months

Izon

Berry

Law

et al. 2020

Clin Psychology and Psychoth

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Individuals with an at-risk mental state (ARMS) of psychosis experience high levels of distress, anxiety, low mood, and suicidal ideation. Families of ARMS individuals provide significant support but are often neglected by services. This study is the first of its kind to use a novel longitudinal qualitative methodology to directly compare family/carers' earlier experiences supporting ARMS individuals to 12 months later. This provides a more ecologically valid insight into how perceptions change over time and how family/carers adapt. Semistructured interviews were conducted with 10 family/carers at two points within a 12-month period. This study was embedded within a randomized control trial, the Individual and Family Cognitive Behavioural Therapy trial. Interview transcripts were analysed using thematic analysis, with a focus on how experiences and reactions for family/carers changed over time. Over 12 months, four factors were important for family/carers to facilitate their caring role. These were summarized in the thematic map (LACE model): Looking after your own well-being; Accessing additional support from family intervention; Communicating openly with the individual; and Engaging with services for the individual. All four aspects of the model were important in improving family communication, meeting family/carers' unmet needs, and helping them to feel more confident and less isolated in their carer role. Novel implications suggest that when feasible, services should involve family/carers of ARMS individuals in sessions and explore family/carer support strategies in managing their own distress. The most significant insight was the need to develop family/carer resources to educate, normalize, and validate their own experiences.

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Section: Carers Of Individuals Experiencing Psychosis Have Increased mentioning

confidence: 99%

Section: Carers Of Individuals Experiencing Psychosis Have Increased mentioning

confidence: 99%

Section: Stagementioning

confidence: 99%

“…Coding was both based on the prior publication themes and subthemes (Izon et al, 2019) but also grounded from the 12-month data (see Table 2). A mixed method approach was adopted.…”

Section: Stagementioning

confidence: 99%

See 2 more Smart Citations

“I don't think I took her fears seriously”: Exploring the experiences of family members of individuals at‐risk of developing psychosis over 12 months

Izon

Berry

Law

et al. 2020

Clin Psychology and Psychoth

Self Cite

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“…[16]. Family psycho-education to acquire additional skills to create warm environments, as well as , personalized to the individual's stage of psychosis and the caregivers' appraisal of the condition could help long-term outcomes for both patients and their relatives [17].…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia

Elsherif¹,

Behilak²,

Abdelraof³

2020

AJNR

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Background: The chronic burden of care to a patient with schizophrenia which produce negative emotions. As a result of de-institutionalization, caregivers have greater burden for the care of their mentally ill relatives. Objective of this study was to explore the relationship of relatives' illness perception, expressed emotion and their burden in caring for patients with schizophrenia. Design: This study followed a correlation descriptive research design. Setting: This study conducted at inpatient and outpatient psychiatric department of Tanta University Hospital. Subject: The study subjects consist of 100 relatives of patient with schizophrenia. Tools: Tool 1 consisted of 2 parts: Part 1 Socio-demographic and general characteristics of studied participants, Part 2 Illness Perception Questionnaire-Schizophrenia Carers Version (IPQ-SCV), Tool 2 Family Questionnaire (FQ), Tool 3 Caregiver Burden Interview. Results: it was found that the studied participants had poor illness perception total score, it was found that the studied subjects (47%) had high emotional over-involvement level while it was observed that the two thirds of the studied relatives (61%) had high level of family criticism. majority of studied participants had moderate level of family burden. Conclusion: The results concluded that there was a significant positive correlation between family illness perception and family expressed emotion, also there was a significant positive correlation between family emotional expression and family burden level. Recommendations: this study recommended future studies to investigate distress and burden among caregivers with high emotion expression for intervention, reducing family stress and burden.

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Investigating expressed emotion in individuals at‐risk of developing psychosis and their families over 12 months

Izon

Berry

Wearden

et al. 2021

Clin Psychology and Psychoth

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High levels of expressed emotion (EE) are present in families of individuals with an at‐risk mental state (ARMS) of psychosis and can negatively impact on service users' functioning and symptoms, as well as relatives' psychological wellbeing. Objectives This is the first longitudinal study to assess EE from the family/carers' perspective, as well as the service users' perceptions of the family/carers' EE. We explored the effects of EE on transition risk and outcomes of depression, worry, and anxiety. Methods Questionnaires were completed by 70 ARMS individuals and 70 family/carers at three time points: baseline, 6 and 12 months. All participants completed measures of anxiety, depression, and worry, plus a version of the Family Questionnaire to assess EE. Results EE scores reduced over time for both service users and family/carers. High EE perceived by service users at 6 months was associated with higher transition to psychosis at 12 months. High‐EE levels at baseline were associated with higher levels of service user depression and family/carer anxiety at 12 months. Higher family/carer total EE scores were associated with less contact with the service user and higher levels of worry. Conclusions Novel implications suggest that interventions to reduce high EE in families of people with ARMS would benefit service users by protecting them from higher levels of depression and transition to psychosis. Reducing high‐EE attitudes would also benefit the family/carers by reducing levels of anxiety and worry. Family interventions focussing on multiple perceptions of the home environment could help to direct services and prevent negative psychological outcomes for all family members.

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Expressed emotion (EE) in families of individuals at-risk of developing psychosis: A systematic review

Cited by 26 publications

References 34 publications

“I don't think I took her fears seriously”: Exploring the experiences of family members of individuals at‐risk of developing psychosis over 12 months

“I don't think I took her fears seriously”: Exploring the experiences of family members of individuals at‐risk of developing psychosis over 12 months

The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia

Investigating expressed emotion in individuals at‐risk of developing psychosis and their families over 12 months

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