Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives

Abstract

Measurements of spontaneous fluctuations in skin conductance in 20 acutely ill schizophrenic patients were made in a video-tape studio. Recordings were made initially with the patient talking to an interviewer, then during a video-taped interview conducted with the patient's key relative. The Expressed Emotion (EE) of the patient's key relative had been measured previously. Significant differences in the type of spontaneous fluctuation activity between patients who had low EE and high EE relatives were demonstrated when the relative was present, but not when the relative was absent. The findings were not related to phenothiazine medication.

Interactions in high- and low-EE families

“…Miklowitz et al (1984) reported a significant association between the EE-level of each parent, and critical and intrusive statements observed in direct interaction between patient and parent. Finally, Tarrier et al (1979) and Sturgeon et al (1981) found significant differences in psychophysiological measures between patients from high-EE and patients from low-EE families. In summary, it can be concluded that the EE-concept is a good predictor of schizophrenic relapse and a valid measure of the relatives' emotional engagement.…”

Toward specifying the nature of the relationship between expressed emotion and schizophrenic relapse: the utility of curvilinear models

“…Although many studies of expressed emotion have emphasized the toxicity of high levels of negative family factors (such as EOI), it is equally plausible that exposure to caregivers who display low levels of a given negative family factor may exert a protective effect on the course of schizophrenia (Teague et al, 1989). For example, several studies have demonstrated that exposure to relatives who display low levels of criticism, hostility, and EOI is associated with decreased autonomic arousal among individuals with schizophrenia (Tarrier et al, 1979;Sturgeon et al, 1981). As increased autonomic activity has been hypothesized to play a critical role in triggering a schizophrenic relapse (Nuechterlein and Dawson, 1984), these results suggest that exposure to caregivers who display low levels of certain family factors can exert a protective effect on the course of schizophrenia.…”

Expressed emotion: current status

“…Two studies based upon the theory that florid symptoms of schizophrenia increase with physiological arousal have suggested that the index patient's galvanic skin response (GSR) habituation is slower in the presence of a household member who has expressed high EE response than in the presence of a family member who has not displayed high EE characteristics toward the patient (Tarrier et al 1979;Sturgeon et al 1981). Arousal was not increased by the high EE relative; instead, the low EE relative exerted a calming effect.…”