Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives: A Follow-up Study

Abstract

Measurements of skin conductance response frequencies (SCRf) were obtained from 30 acutely ill schizophrenic patients during a standardised videotaped interview, conducted with the patient's key relative present. Significant differences in SCRf's were demonstrated between patients whose relatives had high and low Expressed Emotion (EE) respectively. Patients at high risk of relapse were allocated either to a control or an experimental group, the latter being offered a number of social interventions in order to reduce the relative's EE and/or contact with the patient. Follow-up measurements were obtained on 19 patients nine months after discharge. Although social intervention was highly successful in reducing relapse rates, its effects did not appear to be directly mediated via SCRf, which was found to be independently related to relapse.

Changes in the Electrodermal Activity of Schizophrenic Patients Associated with Change in the Expressed Emotion Status of Their Relatives

“…An ideal opportunity to in vestigate this possibility is offered by con trolled intervention studies which attempt to change the relatives' EE status through family intervention. Two such intervention studies have used the measurement of elec trodermal activity in the relative-absent and relative-present paradigm, as described above, as an assessment measure [Leff et al, 1982;Tarrier et al, 1988b], The results from the first study did not find that changes in the relatives' EE status were accompanied by changes in the patients' electrodermal activ ity [Sturgeon et al, 1984], However, in this study subject numbers were low and further decreased by drop-outs at the 9-month fol low-up. The results of the second study, which had considerably larger subject num bers, are presented in this paper.…”

“…Skin conductance levels were recorded using sim ilar instrumentation and procedure as described by Sturgeon et al [1984], Beckman silver/silver chloride electrodes were attached to the fore and middle fin gers of the right hand. A bipolar electrode placement was employed.…”

Spontaneous Fluctuations of Electrical Skin Conductance and the Actual Clinical State in Schizophrenics

“…This fact is illustrated by the concepts of Expressed Emotions and Vulnerability, two highly in fluential approaches in current theorizing with regard to schizophrenia. Both concepts allude to the autonomic nervous system [Tarrier et al, 1979;Sturgeon et al, 1981Sturgeon et al, , 1984Dawson and Nuechterlein, 1984]. They con sider spontaneous fluctuations (SF) in elec trical skin conductance to index the tonic aspect of autonomic arousal.…”

Electrodermal Activity as a Predictor of Schizophrenic Relapse

“…A series of studies have demonstrated that patients living with a high EE relative have higher levels of electrodermal arousal in the presence of that relative compared to patients living with low EE relatives [Stur geon et al, 1984;Tarrier, 1989a;Barrowclough, 1984, 1987;Tarrier et al, 1979Tarrier et al, , 1988a, To further support the suppo sition that arousal levels are the link between EE and relapse it is necessary to demonstrate an association between elevated levels of arousal and relapse. However, both Sturgeon et al [1984] and Tarrier [1989b] reported that electrodermal activity recorded at index admission failed to discriminate between pa tients who remained well and those who relapsed during a 9-month follow-up period. Tarrier and Barrowclough [1987] in a longi tudinal study of a single case found that although electrodermal activity was reactive to environmental factors such as the rela tives' EE status, there was also a suggestion that stable elevated levels of arousal (a mean of 6 non-specific skin conductance re sponses, NS-SCRs/min or above) would pre dict relapse over a 2-year period and possi bly represented a biological vulnerability to repeated episodes.…”