Guilt proneness and expressed emotion in relatives of patients with schizophrenia or related psychoses

Bentsen, Håvard; Notland, Tor Helge; Munkvold, Ole‐Georg; Boye, Birgitte; Ulstein, Ingun; Bjørge, Heidi; Uren, G.; Lersbryggen, Annette B.; Oskarsson, K. H.; Berg-Larsen, R.; Lingjaerde, O; Malt, Ulrik Fredrik

doi:10.1111/j.2044-8341.1998.tb01374.x

Cited by 33 publications

(29 citation statements)

References 47 publications

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“…However, Scazufca and Kuipers (1998) have reported that EE remained constant in two-thirds of the family members recruited and changes in EE levels in the families were predicted by changes in family burden and extent of contacts between patient and family within a 9-month follow-up period. Bentsen et al (1998) also found that the three domains of EE (criticism, hostility and emotional over-involvement) are associated with patient and family variables such as patient's functioning and caregiver's emotional state. Therefore, EE has often been used as a measure of treatment outcome for schizophrenic patients.…”

Section: Literature Reviewmentioning

confidence: 81%

Further validation of the Chinese version of the Level of Expressed Emotion Scale for research and clinical use

Chien

Chan

2010

International Journal of Nursing Studies

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Background: Expressed emotion is a construct that has been used for the past three decades to describe family members' criticism, hostility and emotional involvement with a mentally ill relative within the context of family interactions and care-giving. In Western countries this construct is used as an outcome measure of interventions for families of people with schizophrenia or other psychotic disorders, but the use of this construct in Chinese populations is somewhat limited.Objective: To test the reliability and validity of a refined Chinese version of the 52-item Level of Expressed Emotion Scale (LEE).Methods: A convenience sample of 405 outpatients with psychotic disorders in Hong Kong and one of their family caregivers were recruited. Patients were asked to complete a set of questionnaires twice over a six-month period, including the Chinese version of the LEE, the Specific Level of Functioning scale and the Brief Psychiatric Rating Scale; while their caregivers completed the Family Assessment Device twice and a demographic data sheet at recruitment. This study was aimed at establishing the internal consistency, reproducibility, responsiveness, and construct validity of the LEE.  This study also provides evidence that similar to Western studies, the construct of expressed emotion of family members in Chinese population consists of four factor solutions, including intrusiveness, expectations of the patient, attitude towards the illness, and emotional involvement.

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Section: Literature Reviewmentioning

confidence: 81%

Further validation of the Chinese version of the Level of Expressed Emotion Scale for research and clinical use

Chien

Chan

2010

International Journal of Nursing Studies

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“…Perhaps the low-criticism relatives have simply reached the insight, either through empathy or experience, that coercive criticism does not work for the behaviours associated with psychosis. If, as attachment theory suggests, a normal reaction to loss involves coercive anger or criticism, we might expect a resolution of EOI behaviour to criticism over a period of time, once some issues of guilt and insecurity [27] in the carer had been worked through. Using this model, we would expect that in most cases, the high EOI of relatives should gradually resolve into high-CC or low-EE responses and we should seldom see a low-EE relative change status to a high-EOI relative except where there is an acute deterioration in the patient's condition.…”

Section: Discussionmentioning

confidence: 98%

Preventing the Entrenchment of High Expressed Emotion in First Episode Psychosis: Early Developmental Attachment Pathways

Patterson

Birchwood

Cochrane

2000

Aust N Z J Psychiatry

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“…Because guilt encourages reparative behaviors, relatives who feel excessively blameworthy regarding the patient's illness may resort to over-involvement or sacrificing conduct in order to mend behaviors and events for which they feel guilty. Indeed, Bentsen et al (1998) found that high levels of guilt-proneness, or a tendency to engage in self-blame, were positively associated with the EOI component of EE. Thus guilt may induce reparative behaviors but simply the wrong kinds (those that are maladaptive).…”

Section: Introductionmentioning

confidence: 99%

“…Following Bentsen et al (1998) who stated that “self-blame is an equivalent of guilt,” the current study uses guilt and self-blame interchangeably. Shame and guilt/self-blame are both self-evaluative emotions (Tracy and Robins, 2006).…”

Section: Introductionmentioning

confidence: 99%

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

Wasserman

Mamani

Suro

2012

Psychiatry Research

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Expressed emotion (EE) is a measure of the family environment reflecting the amount of criticism and emotional over-involvement expressed by a key relative towards a family member with a disorder or impairment. Patients from high EE homes have a poorer illness prognosis than do patients from low EE homes. Despite EE's well-established predictive validity, questions remain regarding why some family members express high levels of EE attitudes while others do not. Based on indirect evidence from previous research, the current study tested whether shame and guilt/self-blame about having a relative with schizophrenia serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed the Five Minute Speech Sample to measure EE, along with questionnaires assessing self-directed emotions. In line with the hypotheses, higher levels of both shame and guilt/self-blame about having a relative with schizophrenia predicted high EE. Results of the current study elucidate the EE construct and have implications for working with families of patients with schizophrenia.

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Guilt proneness and expressed emotion in relatives of patients with schizophrenia or related psychoses

Cited by 33 publications

References 47 publications

Further validation of the Chinese version of the Level of Expressed Emotion Scale for research and clinical use

Further validation of the Chinese version of the Level of Expressed Emotion Scale for research and clinical use

Preventing the Entrenchment of High Expressed Emotion in First Episode Psychosis: Early Developmental Attachment Pathways

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

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