Expressed Emotion in Depressed Patients and Their Partners

Florin, Irmela; Nostadt, Anja; Reck, Corinna; Franzen, Ule; Jenkins, Melissa

doi:10.1111/j.1545-5300.1992.00163.x

Cited by 29 publications

(22 citation statements)

References 28 publications

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“…Woo et al also found that patients from low EE homes displayed a pattern of subclinical psychopathology that was distinctly different from those in high EE families and characterized by high levels of nonverbal and paraverbal expressions of anxiety. These findings are consistent with transactional conceptualizations of the EE construct that emphasize the reciprocal influence that family members' attitudes and patient behavior may have on one another (Coiro & Gottesman, 1996;Florin et al, 1992).…”

supporting

confidence: 85%

Relatives' Affective Style and the Expression of Subclinical Psychopathology in Patients with Schizophrenia

2004

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High expressed emotion (EE) is a measure of hostile, critical, and emotionally overinvolved attitudes expressed by a family member about a psychiatrically ill relative during an interview conducted in the patient's absence. EE is a robust predictor of relapse in schizophrenia, yet attempts to identify clinical characteristics that differentiate patients from high versus low EE families have mostly yielded negative findings. However, in a previous study, we found that patients with schizophrenia from high EE families exhibited greater levels of subclinical psychopathology when interacting with family members than did patients from low EE families. Patients from high EE families (N=32) also demonstrated considerable heterogeneity in their expression of subclinical psychopathology. The present study extends our previous work by demonstrating that this heterogeneity in patient subclinical psychopathology was associated with the extent to which family members expressed high EE congruent behaviors--as measured by the affective style (AS) coding system--when directly interacting with their patient-relative. Elevations in anxious/agitated behaviors and hostile/unusual behaviors were observed among patients whose high EE relatives behaved in a manner consistent with their EE status. These findings support a complex, bidirectional model of the role of high EE attitudes in influencing the course of schizophrenia.

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supporting

confidence: 85%

Relatives' Affective Style and the Expression of Subclinical Psychopathology in Patients with Schizophrenia

2004

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“…The patterns in Hooley's subjects might be one of rigid complementarity, with the patients one‐down and the spouses one‐up. However, Florin et al . (1992) found depressed patients more likely to be high EE than their spouses.…”

Section: Discussionmentioning

confidence: 99%

“…Although researchers have long since abandoned the idea of “schizophrenogenic mothers” and distant fathers “causing” schizophrenia, EE research still emphasizes parents' contribution to a highly stressful environment and thus to relapse. In his commentary on a recent report of research measuring EE levels of statements by both patients and their spouses (Florin, Nostadt, Reck, et al ., 1992), Goldstein (1992) emphasizes the importance of challenging assumptions that EE is a unidirectional process in which relatives are solely responsible for the negative environment.…”

Section: Introductionmentioning

confidence: 99%

Relational Control Patterns and Expressed Emotion in Families of Persons with Schizophrenia and Bipolar Disorder

Wuerker

1994

Family Process

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The process of relational control, that is, the negotiation of "who's in charge," was examined in 40 families of persons with schizophrenia and bipolar disorder. Verbal interaction recorded during problem-solving tasks was coded with the Relational Control Coding System (RCCS). Patterning of message and response sequences was compared by diagnosis of the patient and level of expressed emotion (EE) of the family. Results indicated that patients with either diagnosis assert control more than their parents, that high-EE families compete for control more than low-EE families, and that families of bipolar patients compete for control whatever their EE status. The most dramatic differences in control patterns were in the dual-parent, high-EE families of persons with schizophrenia, in which the patients successfully challenged parents for control, and parents often yielded. It was concluded that EE reflects transactional processes in families that vary by diagnosis of the patient.

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“…To our knowledge, no studies have looked at family EE profiles. Only two studies have rated EE from patients toward family members . The current exploratory study examined family EE profiles for adolescents in treatment for bulimia nervosa (BN) and their parents.…”

Section: Introductionmentioning

confidence: 99%

“…Only two studies have rated EE from patients toward family members. 14,15 The current exploratory study examined family EE profiles for adolescents in treatment for bulimia nervosa (BN) and their parents. Associations between parent and patient EE were examined, and the relationship of family EE profile to treatment outcome was assessed.…”

Section: Introductionmentioning

confidence: 99%

A bidirectional examination of expressed emotion among families of adolescents with bulimia nervosa

Rienecke

Lebow

Grange

2014

Intl J Eating Disorders

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Objective The purpose of this paper was to examine expressed emotion (EE) measured from adolescents with bulimia nervosa (BN) toward their parents, in addition to measuring EE from parents toward patients. Method Fifty-four adolescents and their parents who were receiving treatment for BN participated in a videotaped family interview, from which ratings of EE were made. Results Parent and patient scores were highly correlated. Four family profiles were created (Low Patient EE/Low Parent EE; High Patient EE/High Parent EE; Low Patient EE/High Parent EE; High Patient EE/Low Parent EE) to determine whether the match between parent and patient EE was related to treatment outcome. The Low Patient EE/Low Parent EE group demonstrated the greatest reduction in purging from baseline to end-of-treatment; the High Patient EE/Low Parent EE group showed the smallest reduction in purging. Discussion Expressed emotion has historically been rated from relatives toward patients, but patients’ own EE may also be related to treatment outcome.

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Expressed Emotion in Depressed Patients and Their Partners

Cited by 29 publications

References 28 publications

Relatives' Affective Style and the Expression of Subclinical Psychopathology in Patients with Schizophrenia

Relatives' Affective Style and the Expression of Subclinical Psychopathology in Patients with Schizophrenia

Relational Control Patterns and Expressed Emotion in Families of Persons with Schizophrenia and Bipolar Disorder

A bidirectional examination of expressed emotion among families of adolescents with bulimia nervosa

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