Causal Attributions About Schizophrenia in Families in China: Expressed Emotion and Patient Relapse.

Abstract

Previous studies have indicated a robust link between relatives' causal attributions and levels of expressed emotion (EE). However, these studies have primarily been conducted in Western cultures. The current study, conducted in China, examined the spontaneous causal attributions made by 54 relatives of schizophrenia patients during the Camberwell Family Interview. Chinese relatives made few controllable and personal attributions overall. Yet as predicted, highly critical and/or hostile EE relatives attributed patients' negative behaviors to more controllable and personal factors. High EE and controllable attributions positively predicted relapse, whereas personal attributions unexpectedly protected against relapse. EE mediated the effect of controllable, but not personal, attributions on relapse. Relatives' use of a particular Chinese characteristic (narrow-mindedness) was integral to the personal dimension's protective effect.

Families and family therapy in Hong Kong

“…This can be explained by the relatives ' causal attributions about the negative behaviours manifested by people in recovery from schizophrenia. Only those critical relatives who viewed challenging behaviours as personal and controllable were predictive of relapse among individuals with schizophrenia (Yang et al, 2004). If relatives had a more benign or social explanation of challenging behaviour they were more likely to show support and concern.…”

“…Previous studies in Hong Kong and mainland China (Ng et al, 2001;Ran et al, 2003b;Yang et al, 2004) have found that high expressed emotion in the form of over-criticism and hostility among family members was predictive of relapse among individuals with schizophrenia. However, moderate levels of overprotectiveness were found not to be predictive (Ng et al, 2001).…”

Is it possible to carry out high-quality epidemiological research in psychiatry with limited resources?

“…Numerous factors were responsible for lack of seeking help for overcoming addiction among substance users [75 ]. Other studies have looked at causal attributions from schizophrenia in families in China [76] and 10-year treatment outcome in traumatized Cambodian refugees [77 ]. A review [78 ] of the home treatment services showed that more than half of the efforts did not go beyond the trial period and the continuation of the treatment program depended on the benefits in decreasing hospitalization.…”

Schizophrenia, culture and neuropsychology: sensory deficits, language impairments and social functioning in Chinese-speaking schizophrenia patients

“…This population was also selected because of the unexplained worse disability and symptomatic outcomes for schizophrenia in Chinese-speaking native populations (Ran et al 2001 ;Hopper et al 2007 ;Cohen et al 2008). While we have previously examined psychosocial factors impacting course (Yang et al 2004(Yang et al , 2008(Yang et al , 2010, the present study investigates a novel mechanism -an interaction between neuropsychology and languagewhich might account for poorer social functioning.…”