The impact of familial expressed emotion on clinical and personal recovery among patients with psychiatric disorders: The mediating roles of self-stigma content and process.

Abstract

The present study examined the associations of familial expressed emotion (EE) with clinical and personal recovery among patients with psychiatric disorders, as well as the potential mechanisms underlying these associations. Guided by the content-process theory of self-stigma, we hypothesized that EE would be negatively associated with clinical and personal recovery and that these associations would be mediated by self-stigma content and process. A total of 311 patients with psychiatric disorders completed questionnaires on their perceptions of EE, self-stigma, and recovery. Structural equation modeling demonstrated that EE was positively associated with self-stigma content and process, which were in turn negatively associated with clinical and personal recovery. The indirect effects of EE on clinical and personal recovery, via self-stigma content and process, were also significant. Multigroup analyses further demonstrated that the impact of EE on self-stigma and recovery was generalizable across patients with psychotic and nonpsychotic disorders. Theoretically, our findings revealed the potential pathways through which EE may adversely affect psychiatric recovery. Practically, our findings highlighted the importance of designing multipronged intervention programs to reduce familial EE and its potential harmful impact on psychiatric patients. In addition to helping family members improve their knowledge about psychiatric disorders and adjust their communication styles, practitioners should help psychiatric patients develop resilience against EE, mitigate self-stigma, and achieve recovery. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Family social networks and personal recovery among Chinese people with mental illness in Hong Kong: The mediating effects of self-esteem and self-efficacy.

“…The results of our study indicated that family criticalness was directly related to personal recovery. This result is consistent with the findings of a previous study (Chan & Lam, 2018). Our findings also showed that family criticalness was indirectly related to personal recovery through the effect of self-esteem.…”

“…Built upon prior research findings that family network size, perceived family support, family criticalness were identified to be related to personal recovery among individuals with mental illness (Biegel et al, 2013;Chan & Lam, 2018;Pernice-Duca, 2010), this study aims to examine the indirect effects of self-esteem and selfefficacy in the relationship between these three family network variables and personal recovery in Chinese people with mental illness in Hong Kong, a Chinese society which is still greatly influenced by Confucian values (Chen et al, 2019). We proposed the following hypotheses: Hypothesis 1: A large family network is associated with a high level of recovery directly and indirectly through the effects of high self-esteem and high self-efficacy.…”

“…Although the social network could provide resources and facilitate a person's recovery, it could also be a source of stress. As documented in the literature, negative aspects of the social network, such as the criticism from social network members, could hinder the recovery process (Chan & Lam, 2018).…”

Relationships of Family Emotional Support and Negative Family Interactions with the Quality of Life among Chinese People with Mental Illness and the Mediating Effect of Internalized Stigma

“…Negative social interactions refer to "unpleasant social encounters and interactions that are characterized by conflict, excessive demands, and/or criticism" [12]. Negative social interactions can exacerbate symptoms and impede recovery from mental illness [13]. Studies have found that negative social interactions are also related to poor quality of life [9,14].…”

Effect of group counseling on the attitude among the family caregivers of patients with mental disorders

“…Based on the role of the family in the prevention, treatment, and rehabilitation of patients with mental disorders, participation of the family is considered as the main principle in the treatment program of patients with mental disorders [20,21]. According to the essential role of family caregivers, their negative attitudes may hinder the procedure of treatment and recovery of patients with mental disorders, whereas the positive attitude may fulfill the patients' needs.…”