Expressed emotion and health outcomes among Mexican-Americans with schizophrenia and their caregiving relatives.

Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA.
The Journal of nervous and mental disease (Impact Factor: 1.81). 02/2010; 198(2):105-9. DOI: 10.1097/NMD.0b013e3181cc532d
Source: PubMed

ABSTRACT Past studies have demonstrated a clear relationship between expressed emotion (EE) and relapse for individuals with schizophrenia. However, little attention has been directed toward exploring whether EE may have negative health consequences for caregivers as well. We recruited 60 Mexican-American family caregivers of individuals with schizophrenia and examined whether EE predicted the health of caregivers and ill relatives approximately 13 months later. For caregiving relatives, the EE indices of emotional over-involvement and warmth were predictive of worse mental health among caregivers at follow-up. There was no association between EE and health outcome among individuals with schizophrenia. Our findings suggest that, among Mexican-Americans, family factors may be associated with health outcomes among individuals with schizophrenia and their caregiving relatives.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In first-episode psychosis, the family is considered an important part in the recovery process. This is often accompanied by significant distress, which is acknowledged in numerous studies. However, little is known about the psychological factors involved.
    Clinical Psychology & Psychotherapy 05/2014; DOI:10.1002/cpp.1907 · 1.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aims and Objectives To clarify the concept of ‘expressed emotion’ and its application to caregivers of older adults with dementia.Background Expressed emotion has been a useful construct for understanding the quality of family relationships affecting patients with mental illness and their caregivers. However, this concept has been developed without precisely defining ‘expressed emotion’ as it pertains to dementia patients. Clarity regarding expressed emotion will enable nurses to apply knowledge of expressed emotion and provide important information for the development of new clinical interventions for this specific population.DesignIntegrative review.MethodsA review of literature on expressed emotion by caregivers of older adults with dementia. The inclusion criteria were: (1) published in English or Chinese during 1970–2012; (2) included both research and theoretical review articles on expressed emotion in nursing and other disciplines such as psychology, psychiatry and sociology. Initially, 236 articles were screened, and finally, 32 articles were evaluated for this review.ResultsEmotional expression and expressed emotion were discussed to clarify the distinctions and address overlap between these two similar terms. In addition, expressed emotion was examined further from three different aspects: trait or state, social control and cross-cultural. Finally, the results of reviewed papers for expressed emotion on dementia patients were explored and synthesised.ConclusionA conceptual definition and a theoretical framework for the concept of expressed emotion are urgently needed to further our understanding of this critical phenomenon. With increasing attention to caregiving for patients with dementia, including the concept of expressed emotion in the research of this field may accelerate understanding of the importance of the family dynamics in advanced ageing caregiving.Relevance to clinical practiceThe expressed emotion concept could guide much of current clinical practice and help professional nurses understand the family's experience and perspective on mental illness, especially regarding dementia within the family.
    Journal of Clinical Nursing 05/2014; 24(3-4). DOI:10.1111/jocn.12619 · 1.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study tests assumptions from the “cognitive model of caregiving” (Kuipers et al., 2010), which aims to inform interventions for carers of people with psychoses. The sample comprised 61 relatives of patients with schizophrenia. Standardized psychological assessments were conducted twice within 6 months including: Involvement Evaluation Questionnaire (IEQ-EU), a short form of the Symptom Checklist 90-R (SCL K9), the Family Questionnaire (FQ), scales measuring control attributions of the Illness Perception Questionnaire for Schizophrenia (IPQS-R) and emotions toward the ill relative. Structural equation modelling was used to analyse data. We identified two pathways: a) from “attributing control to relatives” to distress, intermediated by anxiety for the patient and emotional overinvolvement (EOI), and b) from “attribution control to patient” to distress, intermediated by anger about the patient and criticism. The model provided a good fit to the data and was successfully replicated at a second point in time. We were able to find supporting evidence for a cognitive model of caregiving. Control attributions and emotions of informal caregivers are important when interventions are planned reducing expressed emotion and burden of caregivers.
    07/2014; 217(3). DOI:10.1016/j.psychres.2014.02.023