Longitudinal Study of the Stability of Expressed Emotion in Families of Schizophrenic Patients: A 9-Month Follow-Up

Santos, Asunción; Espina, Alberto; Pumar, Begoña; González, Pilar; Ayerbe, Ana; García, Enrique

doi:10.1017/s1138741600005667

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…Indeed, caregiver EE can change over the course of treatment for EDs (Moskovich et al, 2017). However, it has been found to revert back to pre-treatment levels over time (Schwarte et al, 2017), consistent with findings in the schizophrenia literature that EE may show temporal stability, particularly for fathers (Santos et al, 2001), although other studies have found that some caregivers do show changes in EE over time, most often changing from high EE to low EE (Scazufca & Kuipers, 1998).…”

Section: Introductionsupporting

confidence: 79%

Expressed emotion and treatment outcome in higher levels of care for eating disorders

Rienecke

Gorrell

Johnson

et al. 2022

Intl J Eating Disorders

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Objective: Expressed emotion (EE) among caregivers toward the affected offspring is a negative prognostic indicator for adolescent patients with eating disorders (EDs) in outpatient treatment. Less research has examined its impact on adolescents in higher levels of care (HLOC). The current study examined differences in caregiver EE according to the subtype of anorexia nervosa (AN) (restricting [AN-R] versus binge/ purge [AN-BP]), and level of care (LOC). We also examined the main effects of baseline caregiver EE (emotional overinvolvement [EOI] or criticism), AN subtype, and their interaction on eating pathology and depression at discharge. Method: Adolescent patients (N = 203) receiving treatment at HLOCs completed measures of ED pathology (Eating Disorder Examination-Questionnaire) and depression (Patient Health Questionnaire-9) at baseline and discharge, and one caregiver of each patient completed a measure of EE (Family Questionnaire) at baseline.Results: No differences in caregiver EE were found between patients with AN-R versus AN-BP, or relative to LOC. Caregiver EE did not predict outcome for ED symptoms or depression at discharge. Discussion: The impact of high caregiver EE may be less substantial at HLOCs than outpatient care given that caregivers are less involved in treatment at HLOCs. Future research is needed to determine if high caregiver EOI leads to poor treatment outcome for adolescents as it does for adults, or whether it is an appropriate expression of care for patients who are ill enough to require HLOC treatment.Public significance statement: High caregiver EE was not found to predict treatment outcome for adolescents with eating disorders in higher levels of care (HLOCs), possibly due to the limited involvement of caregivers in HLOCs. However, patients step down to outpatient treatment, where high caregiver EE can have a significant negative impact on outcome. HLOCs should incorporate efforts to reduce high caregiver EE in anticipation of step-down to outpatient treatment.

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Section: Introductionsupporting

confidence: 79%

Expressed emotion and treatment outcome in higher levels of care for eating disorders

Rienecke

Gorrell

Johnson

et al. 2022

Intl J Eating Disorders

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“…In the context of Spanish mental health care, previous reports have indicated that psychoeducational intervention alone may be ineffective to change parents' perceptions of subjective distress and burden (Cañive et al, 1993). On the other hand, EE has proved to be relatively stable in Spanish families with schizophrenia when their relatives are not in crisis (Santos et al, 2001). It can be argued that the fact that the intervention was provided when patient have reached a clinical remission could attenuate the possibilities of finding changes in EE and burden.…”

Section: No Changes In Levels Of Expressed Emotion and Family Burdenmentioning

confidence: 99%

Effects of Family Psychoeducation on Expressed Emotion and Burden of Care in First-Episode Psychosis: A Prospective Observational Study

et al. 2010

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The present study aimed to examine the levels and interactions of family burden (FB) and expressed emotion (EE) in first episode psychosis (FEP) patients and, secondly, to observe the potential change after a brief psychoeducational group intervention implemented in a real world clinical setting. Twenty-three key relatives of FEP patients received a brief psychoeducational group intervention. FB and EE were assessed before and after the intervention. EE-change and correlations between variables were examined. Half of the sample of key-relatives showed high levels of EE. No severe family burden was observed. FB and EE did not change after the intervention. Family subjective and objective burden were correlated with emotional overinvolvement, but not with criticism. Brief psychoeducational groups may not be sufficient to reduce FB and EE associated to the experience of caregiving for a family member with a first-episode psychotic disorder.

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“…Also, parent depression was not correlated with criticism. Previous research presents mixed findings for this relationship and some authors have argued that criticism more closely resembles a trait, whereas EOI, especially in mothers, may be particularly exacerbated in stressful situations and may therefore be more likely to be associated with distress following a traumatic event [59][60][61]. This relationship may become stronger over time [e.g.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Relationship between posttraumatic stress symptoms, caregiving response, and parent mental health in youth exposed to single incident trauma

Goddard

Onwumere

Meiser‐Stedman

et al. 2019

Journal of Affective Disorders

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  The results of this study indicate that the stress experienced by parents in the aftermath of a traumatic event that affected their child impacts upon parenting factors that are associated with child psychopathology.  Expressed emotion and family accommodation are associated with posttraumatic stress reactions in young people in the month following a traumatic event, and child stress in response to emotional overinvolvement mediates this effect.  Parental posttraumatic stress symptoms and anxiety were associated with emotional overinvolvement and accommodating behaviours.  The measurement of expressed emotion was comprehensive and allowed for analysis of the specific components from multiple perspectives.  The inclusion of a measure of family accommodation provides new data on how families may respond to a child"s distress following a difficult and injurious life event.  Understanding the child in the context of their family environment and relationships offers an important framework for making sense of and facilitating adaptive adjustment following a traumatic event.  Specific skills training for parents may be of benefit for a youth population at risk of developing persistent traumatic stress reactions, and including parents in interventions offered to young people may improve their effectiveness.

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Longitudinal Study of the Stability of Expressed Emotion in Families of Schizophrenic Patients: A 9-Month Follow-Up

Cited by 10 publications

References 24 publications

Expressed emotion and treatment outcome in higher levels of care for eating disorders

Expressed emotion and treatment outcome in higher levels of care for eating disorders

Effects of Family Psychoeducation on Expressed Emotion and Burden of Care in First-Episode Psychosis: A Prospective Observational Study

Relationship between posttraumatic stress symptoms, caregiving response, and parent mental health in youth exposed to single incident trauma

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