Expressed Emotion and Health Outcomes Among Mexican-Americans With Schizophrenia and Their Caregiving Relatives

Breitborde, Nicholas J. K.; López, Steven R.; Kopelowicz, Alex

doi:10.1097/nmd.0b013e3181cc532d

Cited by 19 publications

(15 citation statements)

References 35 publications

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“…There have been many studies on both the relationship between EE and depression in patients (Hayhurst, Cooper, Paykel, Vearnals, & Ramana, 1997;Hinrichsen, Adelstein & Mcmeniman, 2004;Silk et al, 2009) and the association between EE and the caregivers' health among patients with schizophrenia (Breitborde et al, 2009;Breitborde, L opez, & Kopelowicz, 2010). A number of studies have also found that EE in caregivers of dementia patients was related to caregivers' strain and distress (Bledin, MacCarthy, Kuipers, & Woods, 1990), burden (Nomura et al, 2005;Vitaliano, Russo, Young, Teri, & Maiuro, 1991), and psychological well-being (Gilhooly & Whittick, 1989).…”

Section: Introductionmentioning

confidence: 96%

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

Lewis

2013

Aging & Mental Health

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The significant relationship between EE and caregivers' mood and perceived burden suggests that caregivers with elevated mood or burden may put persons with dementia at greater risk for toxic, negative interactions from them. Although this study's design precludes attributing directionality, more depressed caregivers are at a greater risk of higher EE which may affect care of their elderly demented family members. Additional research is warranted with a larger sample size and/or a longitudinal design.

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Section: Introductionmentioning

confidence: 96%

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

Lewis

2013

Aging & Mental Health

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“…Meanwhile, the burden of the caring role has been shown to significantly deplete family social networks, an important buffer for stress [16]. Although less is known about the physical health correlates of caring for a relative with psychosis, there is evidence that the style of caring and severity of psychotic symptoms increases the risk of physical health problems for relatives [17, 18]. Findings from investigations of Alzheimer’s disease provide a basis for further hypotheses – studies have suggested that stress is associated with weakening of carers’ immune functioning and accelerated ageing [19].…”

Section: Introductionmentioning

confidence: 99%

Moderated online social therapy for carers of young people recovering from first-episode psychosis: study protocol for a randomised controlled trial

Gleeson

Lederman

Herrman

et al. 2017

Trials

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BackgroundFirst-episode psychosis most often has its onset during late adolescence. In caring for the young person, families endure high levels of stress and depression. Meanwhile, the social networks of families often erode. Our group has previously shown that family cognitive behaviour therapy (CBT) leads to significantly improved perceived stress compared with specialist first-episode treatment as usual; however, there are well-known barriers to the dissemination of effective family interventions. To address this, we have developed a novel online intervention entitled ‘Altitudes’ that fully integrates purpose-built online social networking, expert and peer moderation, and evidence-based psychoeducation within a single application. The primary aim of this trial is to evaluate the effectiveness of Altitudes in reducing stress in carers over a 6-month period.Methods/designWe describe here a single-blinded cluster randomised controlled trial (cRCT) with permutated blocks. The clusters comprise individual families. The two treatment conditions include Altitudes plus Specialist Treatment as Usual (STAU) and STAU alone. Altitudes involves participation in our novel online programme whereas STAU comprises specialist family work at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. We aim to recruit 160 family members of young, 15–27 year-old, patients registered for treatment for first-episode psychosis (FEP) at EPPIC. The design includes two assessment time points, namely, baseline and 6-month follow-up. The study is due for completion within 2 years including an 18-month recruitment period and a 6-month treatment phase. The primary outcome is carers’ perceived stress at 6 months. Secondary outcome measures include a biomarker of stress, depressive symptoms, worry, substance use, loneliness, social support, satisfaction with life, and a range of measures that tap into coping resources. We seek to gain a dynamic picture of carer stress through our Smartphone Ecological Momentary Assessment (SEMA) tool.DiscussionThis is the first randomised controlled trial designed to evaluate an online intervention for carers of young people recovering from FEP. It has the potential to produce evidence in support of a highly novel, accessible, and cost-effective intervention to reduce stress in carers who are providing support to young people at a critical phase in their recovery from psychosis.Trial registrationAustralian New Zealand Clinical Trial Registry, identifier: ACTRN12616000968471. Retrospectively registered on 22 July 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1775-5) contains supplementary material, which is available to authorized users.

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“…While expressed emotion, or expressions of over-involvement (“smothering”), criticism or hostility vary from individual to individual; these expressions also vary cross-culturally (41). Moreover, the phenomenon of familial expressed emotion predicts different outcomes depending on the ethnicity of individuals; higher expressed emotion has been linked with poorer outcomes in non-Hispanic whites but not in Hispanic individuals in schizophrenia treatment (42–43). At present, there is a dearth of literature on minority couples in treatment.…”

Section: Discussionmentioning

confidence: 99%

Assessing Treatment Integrity in Alcohol Behavioral Couple Therapy

Hallgren

Crotwell

Muñoz

et al. 2016

Addictive Disorders &Amp; Their Treatment

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Objectives Alcohol Behavioral Couple Therapy (ABCT) is an efficacious treatment for alcohol use disorders. Coding treatment integrity can shed light on the active ingredients of ABCT, but there are no published studies of treatment integrity instruments for ABCT. The present study describes the development and initial reliability of the Treatment Integrity Rating System – Couples Version (C-TIRS) for ABCT. Methods The C-TIRS was used to rate 284 first- and mid-treatment ABCT sessions of 188 couples in four randomized clinical trials. Results Average inter-rater reliability for distinguishing ratings between C-TIRS items was fair-to-good for quantity items (intraclass correlation [ICC] = 0.64) and poor-to-fair for quality items (ICC = 0.41). Five C-TIRS subscales were defined a priori to measure treatment components involving cognitive-behavioral therapy, spouse involvement, couple therapy, common therapeutic factors, and overall adherence to the treatment protocol and had adequate internal reliability (α = 0.74–0.89). Inter-rater reliability was fair to good on seven of ten scales but poor on three scales (ICC range = 0.17–0.72). Conclusions The C-TIRS was designed to provide information about quantity and quality of the delivery of ABCT components; however, further refinement of the C-TIRS is warranted before it should be used in frontline practice. Clinical implications and recommendations for future research are discussed.

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Expressed Emotion and Health Outcomes Among Mexican-Americans With Schizophrenia and Their Caregiving Relatives

Cited by 19 publications

References 35 publications

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

Moderated online social therapy for carers of young people recovering from first-episode psychosis: study protocol for a randomised controlled trial

Assessing Treatment Integrity in Alcohol Behavioral Couple Therapy

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