Emotional Attitudes and Direct Communication in the Families of Schizophrenics

Strachan, Angus M.; Leff, Julian; Goldstein, Michael J.; Doane, Jeri A.; Burtt, C

doi:10.1192/bjp.149.3.279

Cited by 104 publications

(76 citation statements)

References 18 publications

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“…Rutter & Brown (3,4) knew at an early date that high levels of EE were associated with direct criticisms of the patient by the carer. This is paralleled by the finding of the negative affective style in relatives (12,13). Not only are high-EE relatives negative in their approach to patients, but the home environment is consequently unpredictable (1 4).…”

Section: Ee As An Indicator Of Family Interactionsmentioning

confidence: 71%

The clinical utility of expressed emotion in schizophrenia

Bebbington

Kuipers²

1994

Acta Psychiatr Scand

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Acro Psidiiotr Scnnd 1994: 89 (suppl 3x2): 46-53 Priiirtd iri Ilciiiiitrrk rill ri,qhrs w w r , c d The clinical utility of expressed emotion in 4 -4 . schizophrenia Bebbington P, Kuipers L. The clinical utility of expressed emotion in schizophrenia. Acta Psychiatr Scand 1994: 89 (suppl. 382): 46-53. Munksgaard 1994.The measure expressed emotion (EE) has been developed over the course of the last 35 years, but it is only over the last decade that there has been an explosion of interest in it. It taps attitudes and behaviour in those who care for people with a range of psychiatric and physical conditions. It has been the basis for successful studies of psychosocial intervention in schizophrenia. However, several questions remain to be answered concerning EE. This article summarizes the results of an aggregate analysis of 25 studies of EE, which appears to be a robust predictor of relapse, in a range of locations and cultures, and in both sexes. Medication and family atmosphere exert effects on relapse that are completely independent.High contact with high-EE relatives increases relapse rates still further, while if anything contact with low-EE relatives is protective. We describe what is known about the relationship of EE with the behaviour of patients and carers. It is now clear that staff members can exhibit the same range of behaviours as the relatives of sufferers. Finally, we set out the implications for the routine management of people with longstanding schizo-I phrenia.

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Section: Ee As An Indicator Of Family Interactionsmentioning

confidence: 71%

The clinical utility of expressed emotion in schizophrenia

Bebbington

Kuipers²

1994

Acta Psychiatr Scand

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“…You have 10 min for this discussion, and I will return after 10 min.” The same procedure was used to gather follow-up interaction data during the final treatment session that occurred 6 months after treatment initiation for the FFT-CHR group, and by either the therapist or a research assistant during the 6 month reassessment for the EC group. This procedure is similar to family behavioral observation assessment strategies used in studies of schizophrenia and bipolar disorder (e.g., Bellack, Haas, & Tierney, 1996; Blanchard, Sayers, Collins, & Bellack, 2004; Miklowitz, Goldstein, Falloon, & Doane, 1984; Strachan, Leff, Goldstein, Duone, & Burtt, 1986) and of clinically high-risk youth (O’Brien et al, 2009). …”

Section: Methodsmentioning

confidence: 99%

A randomized trial of family focused therapy with populations at clinical high risk for psychosis: Effects on interactional behavior.

O’Brien¹,

Miklowitz²,

Candan³

et al. 2014

Journal of Consulting and Clinical Psychology

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Objective This study investigated whether family focused therapy (FFT-CHR), an 18-session intervention that consisted of psychoeducation and training in communication and problem solving, brought about greater improvements in family communication than enhanced care (EC), a 3-session psychoeducational intervention, among individuals at clinical high risk for developing psychosis. Method This study was conducted within a randomized controlled trial across 8 sites. We examined 10-min problem-solving discussions at baseline and 6-month reassessment among 66 adolescents and young adults and their parents. Trained coders who were blind to treatment and time of assessment achieved high levels of interrater reliability when evaluating family discussions on categories of calm–constructive and critical– conflictual behavior. Results Individuals at high risk and their family members who participated in FFT-CHR demonstrated greater improvement from baseline to 6-month reassessment in constructive communication and decreases in conflictual behaviors during family interactions than those in EC. Participants in FFT-CHR showed greater increases from baseline to 6 months in active listening and calm communication and greater decreases in irritability and anger, complaints and criticism, and off-task comments compared to participants in EC. These changes occurred equally in high-risk participants and their family members. Conclusions A 6-month family skills training treatment can bring about significant improvement in family communication among individuals at high risk for psychosis and their parents. Future studies should examine the association between enhancements in family communication and reduced risk for the onset of psychosis among individuals at high risk.

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“…You have ten minutes for this discussion.” The research assistant started the video camera and left the room. This procedure is similar to other behavioral observation assessment strategies used in studies of families of patients with schizophrenia (e.g., Miklowitz et al, 1984; Bellack et al, 1996; Blanchard et al, 2004; Strachan et al, 1986) and has been found to differentiate between families with high and low expressed emotion (Miklowitz et al, 1984; Strachan et al, 1986). …”

Section: Methodsmentioning

confidence: 99%

Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: A longitudinal study

O’Brien

Zinberg

et al. 2009

Schizophrenia Research

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This study prospectively examined the relationship between social problem solving behavior exhibited by youths at ultra-high risk for psychosis (UHR) and with recent onset psychotic symptoms and their parents during problem solving discussions, and youths' symptoms and social functioning six months later. Twenty-seven adolescents were administered the Structured Interview for Prodromal Syndromes and the Strauss-Carpenter Social Contact Scale at baseline and follow-up assessment. Primary caregivers participated with youth in a ten minute discussion that was videotaped, transcribed, and coded for how skillful participants were in defining problems, generating solutions, and reaching resolution, as well as how constructive and/or conflictual they were during the interaction. Controlling for social functioning at baseline, adolescents' skillful problem solving and constructive communication, and parents' constructive communication, were associated with youths' enhanced social functioning six months later. Controlling for symptom severity at baseline, we found that there was a positive association between adolescents' conflictual communications at baseline and an increase in positive symptoms six months later. Taken together, findings from this study provide support for further research into the possibility that specificfamily interventions, such as problem solving and communication skills training, may improve the functional prognosis of atrisk youth, especially in terms of their social functioning.

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Emotional Attitudes and Direct Communication in the Families of Schizophrenics

Cited by 104 publications

References 18 publications

The clinical utility of expressed emotion in schizophrenia

The clinical utility of expressed emotion in schizophrenia

A randomized trial of family focused therapy with populations at clinical high risk for psychosis: Effects on interactional behavior.

Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: A longitudinal study

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