Expressed emotion is not associated with disorder severity in first-episode mental disorder

Heikkilä, Jyrki; Karlsson, Hasse; Taiminen, Tero; Lauerma, Hannu; Ilonen, Tuula; Leinonen, Kirsi-Marja; Wallenius, Elina; Virtanen, Heli; Heinimaa, Markus; Koponen, Seppo; Jalo, Päivi; Kaljonen, Anne; Salakangas, Raimo K. R.

doi:10.1016/s0165-1781(02)00134-8

Cited by 53 publications

(34 citation statements)

References 54 publications

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“…This study found that 37.7 % of caregivers could be characterized as having high expressed emotion, which is slightly less than that reported in some other FEP samples [20,44,45] but considerably less than found by McNab et al [46] (73.5 %). While EOI was a strong predictor of caregiver distress in the linear mixed model analysis, criticism did not significantly contribute to the model that was fitted.…”

Section: Expressed Emotion and Distresscontrasting

confidence: 74%

Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology

Jansen

Haahr

Harder

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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Caregiver distress is significant in the early phase of illness, and this seems to be more related to their subjective appraisal and over-involvement, than to variations in symptoms and global functioning of the person diagnosed with FEP. This lends further support to the stress-appraisal coping model and the cognitive model of caregiving in FEP, and highlights supportive interventions aimed at handling unhelpful cognitions and behaviors.

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Section: Expressed Emotion and Distresscontrasting

confidence: 74%

Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology

Jansen

Haahr

Harder

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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“…Several reports did not actually find any association between EE levels and demographic [18,41-43] or clinical [19,44-47] characteristics of patients. In our study, the educational status of the patient was the only demographic characteristic of patients and relatives which was statistically associated with, and found to be an independent predictor of, high EE.…”

Section: Discussionmentioning

confidence: 99%

The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population

2012

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BackgroundAn appropriate understanding of the association between high-Expressed Emotion (EE) in family members of people with schizophrenia, patients’ and relatives’ correlates is needed to improve adaptation of psychoeducational interventions in diverse cultures. The aim of this study was to test the hypothesis that relatives designated as high EE would report higher subjective burden of care, and would be associated with objective variables that indicate greater illness severity i.e. number of previous hospitalizations and duration of illness.MethodsWe performed secondary analyses of baseline data from a randomized controlled trial conducted in Italy.ResultsHigh-EE relatives reported more subjective burden of care in disturbed behaviours and adverse effects areas, but did not perceive more deficits in social role performances. As regards illness severity characteristics, neither the number of previous hospital admissions nor the duration of illness was associated with high-EE. However, patients’ previous psychosocial functioning, as measured by educational attainments, seems to protect the relative from high-EE status.ConclusionThere is a need for cross-cultural comparisons of the subjective experience of distress and burden among high EE carers as a target for intervention, aimed at reducing family stress as much as improving patient outcomes.

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“…One reason that the range of criticisms might have been so low relates to the choice of assessment tool. Findings from various studies indicate that FMSS has the propensity to categorize 20% or more of the people categorized as high EE on the CFI as low EE (Heikkila et al, 2002; Hirokazu et al, 2002; Hooley & Parker, 2006). In sum, although it is more time-consuming than the FMSS, the CFI may be a better measure of criticism.…”

Section: Discussionmentioning

confidence: 99%

The Role of Depression, Shame-Proneness, and Guilt-Proneness in Predicting Criticism of Relatives Towards People With Bipolar Disorder

McMurrich

Johnson

2009

Behavior Therapy

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Expressed emotion (EE) has been associated with poor patient outcomes in many different psychiatric disorders. Given its robust association with relapse, EE has become a major target of family psychoeducational interventions. Most psychoeducational interventions to date have failed to change EE levels among families of those with bipolar disorder. Better intervention strategies, then, may depend on an increased understanding of the predictors of EE. Although EE has traditionally included many facets, criticism appears to be the most robust predictor of outcome within bipolar disorder. The present study tested three primary predictors of criticism among family members of people with bipolar disorder: shame-proneness, guilt-proneness, and depression. Depressive symptoms were significantly associated with EE. Discussion focuses on limitations and implications of the study and suggestions for future research.

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Expressed emotion is not associated with disorder severity in first-episode mental disorder

Cited by 53 publications

References 54 publications

Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology

Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology

The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population

The Role of Depression, Shame-Proneness, and Guilt-Proneness in Predicting Criticism of Relatives Towards People With Bipolar Disorder

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