Criticism and hostility in relatives of patients with schizophrenia or related psychoses: demographic and clinical predictors

Abstract

Relatives' criticism and hostility are important risk factors for relapse in schizophrenia. In order to explain these attitudes, we examined a Norwegian sample of 47 recently hospitalized patients (with schizophrenia or related psychoses) and 72 relatives. Relatives' expressed emotion was assessed by means of the Camberwell Family Interview. Demographic and clinical data were used as predictor variables in confirmatory regression analyses. The most robust predictors of high levels of criticism were, on the part of the patient, lack of paid employment, more than 3 previous hospital admissions, more troublesome behaviours reported by relatives, especially anxiety/depression, and better cognitive functioning at admission. Robust predictors of hostility were lack of employment and more than 3 previous hospitalizations. Interventions to reduce criticism should include employing patients and working with relatives' unrealistic expectations.

What do We Know about Family Interventions for Psychosis at the Process Level? A Systematic Review

“…In a review, Barrowclough and Hooley () suggest attributions of relatives about patients’ behavior may mediate EE. Other descriptive studies of this category that demonstrate what specific attribution‐elements affect EE also supported this finding, namely: (1) patient's locus of control, agency, and self‐efficacy on their problematic behavior (Bentsen et al., ; Breitborde, Lopez, & Nuechterlein, ); and (2) expectations about the patient's employment (Bentsen, Notland, Boye, et al., ).…”

Empowering caregivers: Impact analysis of FamilyLink Education Programme (FLEP) in Hong Kong, Taipei and Bangkok

“…Generally, it has been women who cater to the daily needs of patients and bear the emotional strain that arises from close interactions with mentally ill family members (Almberg, Grafstrom, & Winblad, 1997; Almberg, Jansson, Grafstrom, & Winblad, 1998; Barusch & Spaid, 1989; Faison, Faria, & Frank, 1999; Kramer & Kipnis, 1995; Parabiaghi, et al., 2007; Sparks, Farran, Donner, & Keane-Hagerty, 1998; Stoller, 1990). Given that women (especially mothers) are usually engaged in more emotional work (Bentsen et al, 1996; Bentsen et al, 1998), the psycho-education programme, which taught new factual and emotional information, would have delivered benefits for the participants. The significant improvements found in this study may be related to the fact that female caregivers constituted the majority of the sample, and they responded better than men in emotion-related and coping-related outcomes in family psycho-education programmes (McWilliams, Hill, Mannion, Kinsella, & O’Callaghan, 2007).…”

Predictors of components of expressed emotion in major caregivers of Turkish patients with schizophrenia

“…Paid employment status of the patient, the patient's level of cognitive functioning, number of hospitalizations and the knowledge level of the caregiver about schizophrenia have been found to be related to criticism and hostility (Bentsen et al 1998;Boye et al 1999). On the other hand, the substance use status of the patient, amount of face-to-face contact with the key relative, being the mother and being a single parent have been found to be related to EOI levels.…”