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Expressed emotion research in schizophrenia: theoretical and clinical implications

Published online by Cambridge University Press:  09 July 2009

Liz Kuipers
Affiliation:
District Services Centre, The Maudsley Hospital, London
Paul Bebbington
Affiliation:
District Services Centre, The Maudsley Hospital, London

Synopsis

The expressed emotion (EE) measure is a robust predictor of relapse in schizophrenia. At least twelve studies from a range of cultures have now shown this, although the authors of one maintain their findings are the result of confounding factors. A thirteenth study which failed to demonstrate a predictive effect was seriously weakened by methodological defects. There is now also evidence for the construct validity of EE, which has been shown to reflect ongoing family interactions. High EE relatives display less effective coping responses, and may adversely affect the patient by creating an unpredictable environment. EE may change with time, and probably reflects the interaction of external stresses, the real problems with the patient, and inappropriate coping responses. The association of high EE with arousal in the patient, as indicated by skin conductance abnormalities, has now been replicated. Although the EE phenomenon can be subsumed under a vulnerability-stress model, the way in which it might mediate relapse has not as yet been specified. Interventions have been successful in reducing relapse, and do so by increasing the tolerance and coping skills of the relatives, and by establishing more realistic expectations. As most have also involved the patient in the process of treatment, they have not fully resolved the question of causal direction.

Future studies will clarify these issues, but will not detract from the value that EE has already had in energizing research. It has also provided a framework within which clinicians have begun to recognize and deal with the disabling problems that beset schizophrenic patients and their families.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

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References

Angermeyer, M. C. (1982). The association between family atmosphere and hospital career of schizophrenic patients. British Journal of Psychiatry 141, 112.CrossRefGoogle ScholarPubMed
Barrowclough, C. & Tarrier, N. (1988). A behavioural intervention with a schizophrenic patient. Behavioural Psychotherapy (in the press.)Google Scholar
Bebbington, P. E. & Kuipers, L. (1988). Social influences on the course of schizophrenia. In Schizophrenia: the Major Issues (ed. Bebbington, P. E. and McGuffin, P.), pp. 201225. Heinemann Medical: London. (In the press.)Google Scholar
Berkowitz, R., Eberlein-Friess, R., Kuipers, L. & Leff, J. (1984). Educating relatives about schizophrenia. Schizophrenia Bulletin 10, 418429.CrossRefGoogle ScholarPubMed
Birchwood, M. & Smith, J. (1987). Schizophrenia. In Coping with Disorder in the Family (ed. Orford, J.), pp. 738. Croom Helm: London.Google Scholar
Birchwood, M., Cochrane, R. & Moore, B. (1988). Family coping behaviour and the course of schizophrenia: a follow-up study. Submitted to Psychological Medicine.Google Scholar
Bledin, K., Kuipers, L.MacCarthy, B. & Woods, R. (1987). EE in the daughters of the demented elderly.Paper presented at the BPS Conference,London.Google Scholar
Brewin, C. R., MacCarthy, B., Duda, K. & Vaughn, C. E. (1988). Attributions and Expressed Emotion in the relatives of patients with schizophrenia. Submitted to Journal of Abnormal Psychology.Google Scholar
Brown, G. W. (1959). Experiences of discharged chronic schizophrenic mental hospital patients in various types of living group. Millbank Memorial Fund Quarterly 37, 105131.CrossRefGoogle Scholar
Brown, G. W. (1985). The discovery of Expressed Emotion: induction or deduction? Introductory chapter. In Expressed Emotion in Families (ed. Leff, J. P. and Vaughn, C.), pp. 725. The Guilford Press: New York.Google Scholar
Brown, G. W. & Birley, J. L. T. (1968). Crises and life changes on the onset of schizophrenia. Journal of Health and Social Behaviour 9, 203214.CrossRefGoogle ScholarPubMed
Brown, G. W. & Rutter, M. L. (1966). The measurement of family activities and relationships. Human Relations 19, 241263.CrossRefGoogle Scholar
Brown, G. W., Carstairs, G. M. & Topping, G. C. (1958). The post hospital adjustment of chronic mental patients. Lancet ii 685689.CrossRefGoogle Scholar
Brown, G. W., Monck, E. M., Carstairs, G. M. & Wing, J. K. (1962). Influence of family life on the course of schizophrenic illness. British Journal of Preventive and Social Medicine 16, 5568.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: replication. British Journal of Psychiatry 121, 241258.CrossRefGoogle ScholarPubMed
Buckkrämer, G., Schulze-Monking, H., Lewandowski, L. & Wittgen, C. (1986). Emotional atmosphere in families of schizophrenic outpatients: relevance of a practice-orientated assessment instrument. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 7984. Springer: Berlin.CrossRefGoogle Scholar
Creer, C. & Wing, J. K. (1974). Schizophrenia at Home. National Schizophrenia Fellowship: Surbiton.Google Scholar
Creer, C., Sturt, E. & Wykes, T. (1982). The role of relatives. In Long-term Community Care: Experience in a London Borough (ed. Wing, J. K.), pp. 2939. Psychological Medicine, Monograph, Supplement 2.Google Scholar
Day, R. (1986). Social stress and schizophrenia: from the concept of recent life events to the notion of toxic environments. In Handbook of Studies on Schizophrenia (ed. Burrows, G. D. and Norman, T. R.), pp. 7182. Elsevier: Amsterdam.Google Scholar
Doane, J. A., West, K. L., Goldstein, M. J., Rodnick, E. H. & Jones, J. E. (1981). Parental communication deviance and affective style: predictors of subsequent schizophrenia spectrum disorders in vulnerable adolescents. Archives of General Psychiatry 38,679685.CrossRefGoogle ScholarPubMed
Doane, J. A., Falloon, I. R. H., Goldstein, M. J. & Mintz, J. (1985). Parental affective style and the treatment of schizophrenia: predicting course of illness and social functioning. Archives of General Psychiatry 42, 3442.CrossRefGoogle ScholarPubMed
Doane, J. A., Goldstein, M. J., Miklowitz, D. J. & Falloon, I. R. H. (1986). The impact of individual and family treatment on the affective climate of families of schizophrenics. British Journal of Psychiatry 148, 279287.CrossRefGoogle ScholarPubMed
Dulz, B. & Hand, I. (1986). Short-term relapse in young schizophrenics: can it be predicted and affected by family (CFI), patient, and treatment variables? An experimental study. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 5975. Springer: Berlin.CrossRefGoogle Scholar
Fadden, G. B., Bebbington, P. E. & Kuipers, L. (1987). The burden of care: the impact of functional psychiatric illness on the patient's family. British Journal of Psychiatry 150, 285292.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. and Pederson, J. (1985). Family management in the prevention of morbidity of schizophrenia. Adjustment of the family unit. British Journal of Psychiatry 147, 156163.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L., McGill, C. W., Razani, J., Moss, H. B. & Gilderman, A. M. (1982). Family management in the prevention of exacerbations of schizophrenia. A controlled study. New England Journal of Medicine 306, 14371440.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L., McGill, C. W., Williamson, M., Razani, J., Moss, H. B., Gilderman, A. M. & Simpson, G. M. (1985). Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two year longitudinal study. Archives of General Psychiatry 42, 887896.CrossRefGoogle ScholarPubMed
Goldstein, M. & Strachan, A. (1986). The impact of family intervention programs on family communication and the shortterm course of schizophrenia. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 185192. Springer: Berlin.CrossRefGoogle Scholar
Goldstein, M., Judd, L. L., Rodnick, E. H., Alkire, A. & Gould, E. (1968). A method for studying social influence and coping patterns within families of disturbed adolescents. Journal of Nervous and Mental Disease 147, 233251.CrossRefGoogle ScholarPubMed
Greenley, J. R. (1986). Social control and Expressed Emotion. Journal of Nervous and Mental Disease 174, 2430.CrossRefGoogle ScholarPubMed
Greedharry, (1987). Expressed Emotion in the families of the mentally handicapped: a pilot study. British Journal of Psychiatry 150, 400402.CrossRefGoogle ScholarPubMed
Hemsley, D. R. (1987). Psychological models of schizophrenia. In Textbook of Abnormal Psychology (ed. Miller, E. and Cooper, P.), Churchill Livingstone: Edinburgh.Google Scholar
Hogarty, G. E. (1985). Expressed Emotion and schizophrenic relapse: implications from the Pittsburgh Study. In Controversies in Schizophrenia (ed. Alpert, M.), pp. 354365. Guilford Press: New York.Google Scholar
Hogarty, G. E., Anderson, C. M., Reiss, D. J., Kornblith, S. J., Greenwald, D. P., Javna, C. D. & Madonia, M. J. (1986). Family psycho-education, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One year effects of a controlled, study on relapse and Expressed Emotion. Archives of General Psychiatry 43, 633642.CrossRefGoogle Scholar
Hooley, J. M. (1985). Expressed Emotion: a review of the critical literature. Clinical Psychology Review 5, 119139.CrossRefGoogle Scholar
Hooley, J. M. & Hahlweg, K. (1986). The marriages and interaction patterns of depressed patients and their spouses: Comparison of high and low EE dyads. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 8596. Springer: Berlin.CrossRefGoogle Scholar
Hooley, J. M., Orley, J. & Teasdale, J. (1986). Levels of Expressed Emotion and relapse in depressed patients. British Journal of Psychiatry 148, 642647.CrossRefGoogle ScholarPubMed
Karno, M.Jenkins, J. H., de la Selva, A., Santana, F., Telles, C., Lopez, S. & Mintz, J. (1987). Expressed Emotion and schizophrenic outcome among Mexican-American families. Journal of Nervous and Mental Disease 175, 143151.CrossRefGoogle ScholarPubMed
Koenigsberg, H. W. & Handley, R. (1986). Expressed Emotion: from predictive index to clinical construct. American Journal of Psychiatry 143, 13611373.Google ScholarPubMed
Köttgen, C., Sonnichsen, I., Mollenhauser, K. & Jurth, R. (1984). Group therapy with the families of schizophrenic patients: results of the Hamburg Camberwell Family Interview Study. III. International Journal of Family Psychiatry 5, 8494.Google Scholar
Kuipers, L. (1979). Expressed Emotion: a review. British Journal of Social and Clinical Psychology 18, 237243.CrossRefGoogle ScholarPubMed
Kuipers, L. & Bebbington, P. E. (1985). Relatives as a resource in the management of functional illness. British Journal of Psychiatry 147, 465471.CrossRefGoogle ScholarPubMed
Kuipers, L., Sturgeon, D., Berkowitz, R. & Leff, J. P. (1983). Characteristics of Expressed Emotion: its relationship to speech and looking in schizophrenic patients and their relatives. British Journal of Clinical Psychology 22, 257264.CrossRefGoogle ScholarPubMed
Kuipers, L., MacCarthy, B., Hurry, J., Harper, R. & Lesage, A. (1988). A counselling project with relatives of the long term mentally ill. II. A low-cost supportive model. Submitted to British Journal of Psychiatry.Google Scholar
Leff, J. P. & Brown, G. W. (1977). Family and social factors in the course of schizophrenia (letter). British Journal of Psychiatry 130, 417420.CrossRefGoogle Scholar
Leff, J. P. & Vaughn, C. E. (1980). The interaction of life events and relatives' Expressed Emotion in schizophrenia and depressive neurosis. British Journal of Psychiatry 136, 146153.CrossRefGoogle ScholarPubMed
Leff, J. P. & Vaughn, C. E. (1981). The role of maintenance therapy and relatives' Expressed Emotion in relapse of schizophrenia: a two year follow up. British Journal of Psychiatry 139, 102104.CrossRefGoogle ScholarPubMed
Leff, J. P. & Vaughn, C. (1985). Expressed Emotion in Families. The Guilford Press: New York.Google ScholarPubMed
Leff, J. P. & Vaughn, C. (1986). First episodes of schizophrenia. British Journal of Psychiatry 148, 215216.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., Eberlein-Fries, R. & Sturgeon, D. (1982). A controlled trial of social intervention in schizophrenic families. British Journal of Psychiatry 141, 121134.CrossRefGoogle Scholar
Leff, J. P., Kuipers, L., Berkowitz, R., Vaughn, C. E. & Sturgeon, D. (1983). Life events, relatives' Expressed Emotion and maintenance neuroleptics in schizophrenic relapse. Psychological Medicine 13, 799806.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R. & Sturgeon, D. (1985). A controlled trial of social intervention in the families of schizophrenic patients: two year follow up. British Journal of Psychiatry 146, 594600.CrossRefGoogle ScholarPubMed
Leff, J. P., Wig, N., Ghosh, A., Bedi, H., Menon, D. K., Kuipers, L., Korten, A., Ernberg, G., Day, R., Sartorius, N. & Jablensky, A. (1987). Influence of relatives' Expressed Emotion on the course of schizophrenia in Chandigarh. British Journal of Psychiatry 151, 166173.CrossRefGoogle ScholarPubMed
Liberman, R. P. (1986). Coping and competence as protective factors in the vulnerability-stress model of schizophrenia. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 201216. Springer: Berlin.CrossRefGoogle Scholar
MacCarthy, B. (1988). The role of relatives. In Community Care in Practice (ed. Lavender, A. and Holloway, F.), pp. 207227. Wiley & Sons: Chichester.Google Scholar
MacCarthy, B., Hemsley, D., Schrank-Fernandez, C., Kuipers, L. & Katz, R. (1986). Unpredictability as a correlate of Expressed Emotion in the relatives of schizophrenics. British Journal of Psychiatry 148, 727730.CrossRefGoogle ScholarPubMed
MacCarthy, B., Kuipers, L., Hurry, J., Harper, R. & Lesage, A. (1988). A counselling project with relatives of the long term mentally ill. I. Evaluation. Submitted to British Journal of Psychiatry.Google Scholar
McCreadie, R. G. & Robinson, A. T. D. (1987). The Nithsdale Schizophrenia Survey. VI. Relatives' Expressed Emotion: prevalence, patterns and clinical assessment. British Journal of Psychiatry 150, 640644.CrossRefGoogle ScholarPubMed
MacMillan, J. F., Gold, A., Crow, T. J., Johnson, A. L. & Johnstone, E. C. (1986 a). The Northwick Park Study of First Episodes of Schizophrenia. IV. Expressed Emotion and relapse. British Journal of Psychiatry 148, 133143.CrossRefGoogle Scholar
MacMillan, J. F., Gold, A., Crow, T. J., Johnson, A. L. & Johnstone, E. C. (1986 b). Expressed Emotion and relapse in schizophrenia. British Journal of Psychiatry 148, 741744.CrossRefGoogle Scholar
MacMillan, J. F., Crow, T. J., Johnson, A. L. & Johnstone, E. C. (1987). Expressed Emotion and relapse in first episodes of schizophrenia. British Journal of Psychiatry 151, 320323.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J. & Falloon, R. H. (1983). Premorbid and symptomatic characteristics of schizophrenics from families with high and low levels of Expressed Emotion. Journal of Abnormal Psychology 92, 359367.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Falloon, R. H. & Doane, J. A. (1984). Interactional correlates of Expressed Emotion in the families of schizophrenics. British Journal of Psychiatry 144, 482487.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., Snyder, K. S. & Mintz, J. (1988). Family factors and the course of bipolar affective disorder. Archives of General Psychiatry 45, 225231.CrossRefGoogle ScholarPubMed
Mintz, J., Mintz, L. & Goldstein, M. J. (1987). Expressed Emotion and relapse in first episodes of schizophrenia: a rejoinder to MacMillan et al. (1986). British Journal of Psychiatry 151,314319.CrossRefGoogle Scholar
Moline, R. A., Singh, S., Morris, A. & Meltzer, H. Y. (1985). Family Expressed Emotion and relapse in schizophrenia in 24 urban American patients. American Journal of Psychiatry 142,10781081.Google ScholarPubMed
Nuechterlein, K. H., Snyder, K. S., Dawson, M. E., Rappe, S., Gitlin, M. & Fogelson, D. (1986). Expressed Emotion, fixed-dose fluphenazine decanoate maintenance, and relapse in recent onset schizophrenia. Psychopharmacology Bulletin 22, 633639.Google ScholarPubMed
Platt, S. (1985). Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychological Medicine 15, 383394.CrossRefGoogle ScholarPubMed
Rutter, M. L. & Brown, G. W. (1966). The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry 1, 3853.CrossRefGoogle Scholar
Salokangas, R. K. R. (1983). Prognostic implications of the sex of schizophrenic patients. British Journal of Psychiatry 142, 145151.CrossRefGoogle ScholarPubMed
Seywert, F. (1984). Some critical thoughts on Expressed Emotion. Psychopathology 17, 233243.CrossRefGoogle ScholarPubMed
Smith, J. & Birchwood, M. J. (1987). Specific and nonspecific effects of educational intervention with families living with a schizophrenic relative. British Journal of Psychiatry 150, 645652.CrossRefGoogle Scholar
Strachan, A. M. (1986). Family intervention for the rehabilitation of schizophrenia. Schizophrenia Bulletin 12, 678698.CrossRefGoogle ScholarPubMed
Strachan, A. M., Leff, J. P., Goldstein, M. J., Doane, A. & Burn, C. (1986). Emotional attitudes and direct communication in the families of schizophrenics: a cross-national replication. British Journal of Psychiatry 149, 279287.CrossRefGoogle ScholarPubMed
Strang, J. S., Falloon, I. R. H., Moss, H. B., Razani, J. & Boyd, J. L. (1981). The effects of family therapy on treatment compliance in schizophrenia. Psychopharmacology Bulletin 17, 8788.Google Scholar
Sturgeon, D., Turpin, D., Kuipers, L., Berkowitz, R. & Leff, J. (1984). Psychophysiological responses of schizophrenic patients to high and low Expressed Emotion relatives: a follow-up study. British Journal of Psychiatry 145, 6269.CrossRefGoogle ScholarPubMed
Szmukler, G. I., Berkowitz, R., Eisler, I., Leff, J. & Dare, C. (1987). Expressed Emotion in individual and family settings: a comparative study. British Journal of Psychiatry 151, 174178.CrossRefGoogle ScholarPubMed
Tamer, N. & Barrowclough, C. (1987). A longitudinal psychophysiological assessment of a schizophrenic patient in relation to the Expressed Emotion of his relatives. Behavioural Psychotherapy 15, 4557.Google Scholar
Tarrier, N., Vaughn, C. E., Lader, M. H. & Leff, J. P. (1979). Bodily reactions to people and events in schizophrenics. Archives of General Psychiatry 36, 311315.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Porceddu, K. & Watts, S. (1988 a). The assessment of psychophysiological reactivity to the Expressed Emotion of the relatives of schizophrenic patients. British Journal of Psychiatry 152, 618624.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., Bamrah, J. S., Porceddu, K., Watts, S. and Freeman, H. (1988 b). The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse. British Journal of Psychiatry (in the press).Google Scholar
Tomaros, V., Vlachonikolis, I. G., Stefanis, C. N. & Madianos, M. (1988). The effect of individual psychosocial treatment on the family atmosphere of schizophrenic patients. Social Psychiatry (in the press).Google Scholar
Turpin, G., Tarrier, N. & Sturgeon, D. (1988). Social psychophysiology and the study of biopsychosocial models of schizophrenia. In Social Psychophysiology: Theory and Clinical Applications (ed. Wagner, H.). Wiley: Chichester.Google Scholar
Valone, K., Goldstein, M. G. & Morton, J. P. (1984). Parental Expressed Emotion and psychophysiological reactivity in an adolescent sample at risk for schizophrenic spectrum disorders. Journal of Abnormal Psychology 93, 448457.CrossRefGoogle Scholar
Vaughn, C. (1986). Patterns of emotional response in the families of schizophrenic patients. In Treatment of Schizophrenia: Family Assessment and Intervention (ed. Goldstein, M. J.Hand, I. and Hahlweg, K.), pp. 7678. Springer: Berlin.Google Scholar
Vaughn, C. & Leff, J. P. (1976 a). The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry 129, 125137.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976 b). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Clinical and Social Psychology 15, 157165.CrossRefGoogle ScholarPubMed
Vaughn, C. E., Snyder, K. S., Jones, S., Freeman, W. B. & Falloon, I. R. H. (1984). Family factors in schizophrenic relapse: replication in California of British research in Expressed Emotion. Archives of General Psychiatry 41, 11691177.CrossRefGoogle ScholarPubMed
Wallace, C. J. & Liberman, R. P. (1985). Social skills training for patients with schizophrenia: a controlled clinical trial. Psychiatry Research 15, 239247.CrossRefGoogle ScholarPubMed
Wig, N. N., Menon, D. K., Bedi, H., Ghosh, A., Kuipers, L., Leff, J. P., Korten, A., Day, R., Sartorius, N., Ernberg, G. & Jablensky, A. (1987 a). The cross-cultural transfer of ratings of relatives' Expressed Emotion. British Journal of Psychiatry 151, 156160.CrossRefGoogle ScholarPubMed
Wig, N. N., Menon, D. K., Bedi, H., Leff, J. P., Kuipers, L., Ghosh, A., Day, R., Korten, A., Ernberg, G., Sartorius, N. & Jablensky, A. (1987 b). The distribution of Expressed Emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh. British Journal of Psychiatry 151, 160165.CrossRefGoogle ScholarPubMed
World Health Organization (1979). Schizophrenia: An International Follow-up Study. John Wiley: Chichester.Google Scholar
Wing, J. K. (1987). Psychosocial factors affecting the long-term course of schizophrenia. In Psyhosocial Treatment of Schizophrenia (ed. Strauss, J. S., Boker, W. and Brenner, H. D.), pp. 1329. Huber: Toronto.Google Scholar
Zubin, J., Magaziner, J. & Steinhauser, J. R. (1983). The metamorphosis of schizophrenia: from chronicity to vulnerability. Psychological Medicine 13, 551571.CrossRefGoogle ScholarPubMed
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