In this study we tested an attributional model of expressed emotion (EE) among Mexican-American families. A sample of 46 key family members of schizophrenic patients were measured on three dimensions: affect toward patient, controllability attributions, and level of EE. Consistent with an attributional model, we found that high EE families (denned on the basis of critical comments) viewed the illness and associated symptoms as residing within the patient's personal control, more so than did low EE families. We also found that attributions held by family members are related to their affective reactions. Specifically, family members who perceived the patient as having control over the symptoms of schizophrenia tended to express greater negative emotions such as anger and annoyance toward the patient than did family members who viewed the symptoms as beyond the patient's personal control. An examination of the types of affects found and their relationship to EE status is discussed, along with implications for this research.

Using a sample of 40 Anglo American family members of schizophrenic patients, the present study replicates and lends cross-cultural support for an attribution-affect model of expressed emotion (EE). Consistent with attribution theory, the authors found that highly critical relatives (high-EE) viewed the illness and associated symptoms as residing more within the patient's personal control as compared with less critical relatives (low-EE). A content analysis classified the types of behaviors and symptoms most frequently criticized by relatives. Symptoms reflecting behavioral deficits (e.g., poor hygiene) were found to be criticized more often than symptoms reflecting behavioral excesses (e.g., hallucinations). In line with an attribution-affect framework, relatives may be less tolerant of behavioral deficits because they are viewed as intentional, whereas behavioral excesses are easily recognized as core symptoms of mental illness.

This study included a sample of 57 Anglo-American, Latino American, and African American patients with schizophrenia and their family members. Findings indicate that for patients, as hypothesized, increasing perceptions of family cohesion was associated with less general emotional distress and fewer psychiatric symptoms. For family members of Latino and African American descent, greater self-reported family cohesion also appeared to have a protective effect against emotional distress, as hypothesized. However, no association was found between family cohesion and general emotional distress for Anglo-American family members. Interestingly, no relationship was found between patients' and their relatives' views of their family environment. Thus, researchers and clinicians working with families are encouraged to attain separate assessments of the family environment from each individual member. Contrary to expectations, religiosity was not associated with patient or family member emotional distress or with patient psychiatric symptoms. Study implications are discussed.

Evidence suggests that schizophrenia is highly responsive to the sociocultural and emotional atmosphere of the family. Therapies have shown an improvement in schizophrenia symptoms following family-oriented interventions. However, most programs are developed and offered in English only, and few are culturally informed. Existing programs may fail to meet the needs of minorities, particularly Hispanics/ Latinos, the largest minority group in the United States. In this article, a broad literature is reviewed, which strongly supports the integration of culturally based treatment approaches with existing psychoeducational familyfocused interventions to enhance treatment programs for Hispanic/Latino patients and families coping with schizophrenia. On the basis of this conceptual integration, an intervention titled "culturally informed therapy for schizophrenia" is described.

The present study uses attribution theory to identify factors that may lead to unfavorable emotional reactions toward patients with schizophrenia and to highlight factors that may contribute to the observed inverse relationship between industrial status of a country and schizophrenia outcome. University students from Mexico and the U.S., 2 countries differing in industrial status, served as participants. Eighty‐eight Mexicans from Guadalajara and 88 Anglo Americans from Los Angeles, California read vignettes of a patient described to meet DSM‐IV criteria for schizophrenia. In one vignette, the patient's disorder was characterized by predominantly positive symptoms (e.g., hallucinations, delusions), whereas in the other vignette negative symptoms (e.g., social withdrawal, apathy) predominated. In support of an attributional approach, negative symptoms were associated with greater perceived control than were positive symptoms. Correspondingly, negative symptoms were found to provoke more intense negative affect and less intense positive affect than were positive symptoms. Some national and gender differences were also found.