Expressed emotion, social skill, and response to negative affect in schizophrenia.

Abstract

The social skills and social perception of schizophrenia patients in response to negative affect was examined as a function of family expressed emotion (EE). Patients participated in a role-play test, a social perception test, and a problem-solving discussion with a family member and were assessed on several measures of symptomatology. EE of family members was evaluated with the Camberwell Family Interview. On the role-play test, patients with less critical relatives became more assertive in response to increased negative affect from a confederate portraying either a family member or friend, but patients with highly critical relatives did not. Patients with highly critical relatives were also less assertive when confronted with negative affect from a confederate portraying a family member rather than a friend. The behaviors of both relatives and patients during a family problem-solving interaction were related to the EE dimensions of criticism, emotional overinvolvement, and warmth. Patient gender was also related to family problem solving but was independent of EE. Patient ratings of affect on a videotaped social perception task were not related to family EE, and there were few differences in psychopathology between patients with high and low EE relatives. The results support the validity of the EE construct as an index of relatives' affective behavior and suggest that patients' social skills, such as assertiveness, may mediate negative affective exchanges in their families.

Assertiveness training: A forgotten evidence‐based treatment.

“…Inpatient populations suffering from serious mental illness and comorbid psychiatric conditions may display deficits across a broad range of functioning. One study found that patients with schizophrenia who had highly critical relatives (also referred to as expressed emotion) were more unassertive than patients with less critical relatives, suggesting that assertiveness may interact with environmental factors; however, it remains unclear whether lack of assertiveness was due to a skill deficit, anxiety, or both (Mueser et al, 1993). In addition to the potential lack of social skill, social withdrawal has been considered to be a core feature of chronic schizophrenia (Gleser & Gottschalk, 1967;McClelland & Watt, 1968;Weinman, 1967).…”

Neurocognition and social skill in older persons with schizophrenia and major mood disorders: An analysis of gender and diagnosis effects

“…In the general population, women tend to have stronger verbal processing skills (Kimura, 1999; Maccoby & Jacklin, 1974) and emotion recognition skills (Hall, 1984). On role-play tests of social skill, women with schizophrenia demonstrate better performance than men (Bellack et al, 1992; Mueser, Bellack, Morrison, & Wade, 1990; Mueser et al, 1993). Women with schizophrenia have also been found to have more intact abilities for processing emotional prosody and semantics than their male counterparts (Bozikas et al, 2006; Scholten, Aleman, & Kahn, 2007).…”

Parent-Child Interactions in Relation to Critical and Emotionally Overinvolved Expressed Emotion (EE): Is EE a Proxy for Behavior?

“…Parental CRIT has also correlated positively with "belittling and blaming" statements made by parents, and negatively with "disclosing and expressing" and "trusting and relying" (Hubschmid & Zemp, 1989). The way that EOI relates to interactions between parents/ relatives and patients has generally been less consistent across the literature compared to CRIT (Miklowitz et al, 1984;Mueser et al, 1993). Some studies have found that high EOI parents make more intrusive statements (Strachan et al, 1986) or more ambiguous and unclear statements (Hubschmid & Zemp, 1989); others have found that they do not differ in behavioral interactions compared to low EOI parents .…”