Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview

1996 ◽  
Vol 26 (4) ◽  
pp. 821-828 ◽  
Author(s):  
H. Bentsen ◽  
B. Boye ◽  
O. G. Munkvold ◽  
G. Uren ◽  
A. B. Lersbryggen ◽  
...  
Keyword(s):  
Predictive Power ◽  
Expressed Emotion ◽  
Rater Reliability ◽  
Group Of Seven ◽  
Schizophrenic Patients ◽  
Family Interview ◽  
Good For ◽  
Level Scale

SynopsisHigh expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2–3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3–4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.

Prediction of Schizophrenic Relapse Using the Parental Bonding Instrument

1988 ◽  
Vol 22 (3) ◽  
pp. 283-292 ◽  
Author(s):  
Gordon Parker ◽  
Penny Johnston ◽  
Linda Hayward
Keyword(s):  
Multivariate Analysis ◽  
Discriminant Function ◽  
Expressed Emotion ◽  
Parental Bonding ◽  
Family Factors ◽  
Weak Links ◽  
Parental Bonding Instrument ◽  
Early Parenting ◽  
Schizophrenic Patients ◽  
Family Interview

After admission, 57 schizophrenic patients completed two versions of the Parental Bonding Instrument (PBI) to assess perceived recent and earlier parenting attributes. The parents were also assessed using the Camberwell Family Interview to generate Expressed Emotion (EE) scores. The schizophrenic patients, compared to matched non-clinical controls, reported a significantly greater chance (50% vs 26%) of exposure to “affectionless control” from their father. Nine months later, the subjects were re-Interviewed and their relapse status determined. The PBI measure assessing parenting over the first 16 years had greater utility than the recent parenting version of the PBI. When re-calibrated, only the father's scores on the early parenting PBI scale discriminated “relapsers” and “non-relapsers”. A multivariate analysis suggested that pre-established illness criteria and other family factors were the clearest predictors, and that PBI-defined constructs (as for EE measures) failed to add significantly to the discriminant function. The extent to which EE and PBI scales might measure similar constructs was examined, with only weak links being suggested.

The Salford Family Intervention Project: Relapse Rates of Schizophrenia at Five and Eight Years

1994 ◽  
Vol 165 (6) ◽  
pp. 829-832 ◽  
Author(s):  
Nicholas Tarrier ◽  
Christine Barrowclough ◽  
Kathleen Porceddu ◽  
Elizabeth Fitzpatrick
Keyword(s):  
Predictive Power ◽  
Expressed Emotion ◽  
Intervention Group ◽  
Family Intervention ◽  
Control Group ◽  
Long Term Effects ◽  
The Family ◽  
Schizophrenic Patients ◽  
Relapse Rates

BackgroundThis study assessed the long-term effects of family intervention on schizophrenic relapse.MethodForty schizophrenic patients who had participated in a family intervention trial and who had not experienced relapse at two years after discharge from the index admission were traced through case notes and hospital records. The percentage of patients experiencing a relapse was estimated for patients in the family intervention group, the high-EE control group, and the low-EE control group, at five years and eight years after discharge.ResultsThere were significantly fewer relapses in the family intervention group than in the high-EE control group at both five years and eight years. The number of relapses in the low-EE control group was lower than in the high-EE control group, but this just failed to reach significance.ConclusionsThe benefit of family intervention and the predictive power of EE are sustained over eight years. Expressed emotion (EE) has remained a remarkably robust predictor of relapse in schizophrenia. Kavanagh (1992) cited 20 out of 23 prospective studies that showed patients who returned to live with high-EE relatives had higher relapse rates over 9–12 months after discharge than did patients returning to live with low-EE relatives. Seventeen of these studies reported this difference to be significant.British Journal of Psychiatry (1994),165, 829–832

Psychiatrists' Ratings of Expressed Emotion

1994 ◽  
Vol 39 (8) ◽  
pp. 358-360 ◽  
Author(s):  
Suzanne King ◽  
Alain D. Lesage ◽  
Pierre Lalonde
Keyword(s):  
Expressed Emotion ◽  
Formal Training ◽  
Agreement Rate ◽  
Schizophrenic Patients ◽  
Family Interview ◽  
Better Than

The purpose of this study was to determine the extent to which psychiatrists are familiar with the concept of expressed emotion and to determine the extent of its use in their day-to-day practices. We also wished to test the ability of psychiatrists to estimate the expressed emotion status of the relatives of their patients. Following the assessment of expressed emotion in 96 relatives using the Camberwell Family Interview, the psychiatrists treating the schizophrenic patients were surveyed about their knowledge of expressed emotion and were asked to estimate the expressed emotion of their relatives. Thirty-five percent of the respondents use the expressed emotion concept daily in their practice. When the Camberwell Family Interview ratings of expressed emotion were compared with those from the psychiatrists, the agreement rate was no better than chance (45.7%). Without formal training in the use of the Camberwell Family Interview, practitioners are cautioned against ascribing an expressed emotion status to the relatives of their patients.

Longitudinal Study of the Stability of Expressed Emotion in Families of Schizophrenic Patients: A 9-Month Follow-Up

2001 ◽  
Vol 4 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Asunción Santos ◽  
Alberto Espina ◽  
Begoña Pumar ◽  
Pilar González ◽  
Ana Ayerbe ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Expressed Emotion ◽  
The Other ◽  
Family Interventions ◽  
Attitude Stability ◽  
Other Hand ◽  
Schizophrenic Patients ◽  
Family Interview ◽  
The Stability

The goal of this paper is to study attitude stability in schizophrenics' relatives, as reflected in the expressed emotion (EE) construct. For this purpose, the EE of 32 families of schizophrenic patients was assessed by means of the Camberwell Family Interview (CFI, Brown, Birley, & Wing, 1972; Vaughn & Leff, 1976b), both initially and at a 9-month follow-up. The results obtained indicate that EE is stable in fathers, whereas in mothers, high EE seems to be influenced by stressful situations, because, when assessed in crisis, EE was not stable, but in-between crises, it was. These results are discussed, as well as their relevance in family interventions aimed at reducing EE, where clinicians should take into account that mothers' EE may drop because of its instability, and not because of the intervention. On the other hand, clinicians should focus especially on fathers, because their high EE is constant, which is stressful to the patient during the follow-up.

Expressed Emotion in the Client-Professional Dyad

2004 ◽  
Vol 20 (4) ◽  
pp. 237-246 ◽  
Author(s):  
G. Van Humbeeck ◽  
Ch. Van Audenhove ◽  
G. Storms ◽  
M. De Hert ◽  
G. Pieters ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Correlation Matrix ◽  
Concurrent Validity ◽  
Positive Relationship ◽  
Expressed Emotion ◽  
Family Interview ◽  
Insufficient Time ◽  
Perceived Criticism

Summary: Background: This article reports on a study of the concurrent validity between the standard expressed emotion instrument, the Camberwell Family Interview (CFI), and two alternative EE measures, the Level of Expressed Emotion (LEE) and the Perceived Criticism Scale (PCS). Methods: The research sample consisted of 56 schizophrenic clients, who were residing in sheltered residences, and 56 professionals. Results: Based on the results of the correlation matrix between all the subscales of the instruments, a significantly positive relationship was found between the criticism scale of the CFI, the total score of the LEE, and the client version of the PCS. These correlations, however, were rather weak, which implies that the three instruments have little in common with each other. The professionals' version of the PCS does not appear to be an EE instrument. Conclusions: The results suggest that the CFI still remains the best instrument for assessing EE in a therapeutic relationship (between a professional and a client). If there is insufficient time to administer the CFI, then the client version of the PCS and the LEE can be used with the qualification that the PCS and LEE also measure other aspects and thus cannot completely replace the CFI. Nevertheless, the research indicates that asking the clients would seem to provide a better indication of the level of the professionals' criticism rather than asking the professionals themselves directly.

scholarly journals COVID-19 Infection-Related Weight Loss Decreases Eating/Swallowing Function in Schizophrenic Patients

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1113
Author(s):  
Takeshi Kikutani ◽  
Yoko Ichikawa ◽  
Eri Kitazume ◽  
Arato Mizukoshi ◽  
Takashi Tohara ◽  
...  
Keyword(s):  
Weight Loss ◽  
Oral Feeding ◽  
Parenteral Feeding ◽  
Psychiatric Ward ◽  
Swallowing Function ◽  
Obesity Index ◽  
Life Prognosis ◽  
Before And After ◽  
Schizophrenic Patients ◽  
Level Scale

Background: In older people with psychoneurological diseases, COVID-19 infection may be associated with a risk of developing or exacerbating dysphagia. The aim of the present study was to examine the relationship between eating/swallowing function and COVID-19 infection. Methods: Subjects were 44 inpatients with confirmed COVID-19 infection being treated for schizophrenia in a psychiatric ward. Eating function was assessed using the Food Intake Level Scale (FILS) before and after infection. We also evaluated age, comorbidities, COVID-19 hospital stay, obesity index, weight loss rate, and chlorpromazine equivalent. Results: Subjects had a mean age of 68.86 years. Pre-infection, 20 subjects had a FILS score of 7–9 (presence of eating/swallowing disorder) and 24 subjects had a score of 10 (normal). Eating function after infection resolution showed decreasing FILS score compared to that before infection in 14 subjects (74.14 years). Six subjects (79.3 years) transitioned from oral feeding to parenteral feeding. A ≥ 10% weight loss during infection treatment was significantly associated with decreased eating function and a transition to parenteral feeding. Chlorpromazine equivalents, comorbidities, and number of days of hospitalization showed no associations with decreased eating function. Conclusions: Preventing malnutrition during treatment for COVID-19 infection is important for improving post-infection life prognosis and maintaining quality of life (QOL).

Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia

1997 ◽  
Vol 171 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Christine Barrowclough ◽  
Michael Parle
Keyword(s):  
Expressed Emotion ◽  
Symptom Control ◽  
Well Being ◽  
Primary Appraisal ◽  
Coping Theory ◽  
Secondary Appraisal ◽  
Multivariate Relationships ◽  
Schizophrenic Patients ◽  
A Prospective Study ◽  
Appraisal Processes

BackgroundIt is argued that coping theory may be useful in attempting to understand how relatives adapt to the demands of living with a schizophrenia sufferer.MethodIn a prospective study, univariate and multivariate relationships were explored between appraisal variables (appraisal of symptom threat (primary appraisal) and perceived symptom control (secondary appraisal)) and (a) expressed emotion, and (b) psychological distress in relatives of schizophrenic patients. The profile of relatives who showed sustained distress over time was also examined.ResultsThe appraisal variables were found to be related to both the concurrent distress (GHQ scores), EE ratings of relatives at the time of the patients relapse and hospitalisation, as well as the subsequent GHQ scores of relatives when the patient was discharged back home. Relatives who showed sustained distress were likely to show high EE and have a longer caring history.ConclusionsThe study gives some support to the theory that appraisal processes underlie how relatives react to having a family member with schizophrenia, and may have implications both for identifying those at risk of poor adaptation, and for understanding strategies that improve well-being.

Expressed emotion and relapse rates in schizophrenic patients

1992 ◽  
Vol 6 (2) ◽  
pp. 172-173
Author(s):  
R. Cohen ◽  
T. Niedermeier ◽  
H. Watzl
Keyword(s):  
Expressed Emotion ◽  
Schizophrenic Patients ◽  
Relapse Rates

The Nithsdale Schizophrenia Surveys. XI: Relatives' Expressed Emotion

1993 ◽  
Vol 162 (3) ◽  
pp. 393-397 ◽  
Author(s):  
R. G. McCreadie ◽  
L. J. Robertson ◽  
D. J. Hall ◽  
I. Berry
Keyword(s):  
Expressed Emotion ◽  
The Third ◽  
Schizophrenic Patients ◽  
Over Time

The level of expressed emotion (EE) in 32 relationships between relatives and schizophrenic patients was assessed on three separate occasions over five years. EE was high on all three occasions in 25% of relatives, low on all three in 38%, and fluctuating in 38%; that is, in the majority of relatives (63%) the level of EE was stable over time. Three relatives who had previously shown high EE had evidence of dementia at the time of the third assessment, and showed low EE. Fourteen patients relapsed at least once over five years; patients who relapsed were evenly spread throughout those living in a home in which EE was consistently high, consistently low, or fluctuating. However, patients living in low-EE homes who did relapse did so significantly less often than those who relapsed and were living in homes in which EE was high or fluctuating. At the time of relapse, EE was not consistently high, and some patients in consistently high-EE homes did not relapse at all over five years.

scholarly journals Factors associated with relapse of schizophrenia

2018 ◽  
Vol 29 (2) ◽  
pp. 59-63
Author(s):  
AKM Akramul Haque ◽  
AHM Kazi Mostofa Kamal ◽  
Zinat De Laila ◽  
Luna Laila ◽  
Helal Uddin Ahmed ◽  
...  
Keyword(s):  
Life Events ◽  
Expressed Emotion ◽  
Stressful Life Events ◽  
Economic Status ◽  
Cross Sectional Study ◽  
High Rate ◽  
Stressful Life ◽  
Cross Sectional ◽  
Significant Difference ◽  
Schizophrenic Patients

Schizophrenia is a chronic psychiatric illness with high rate of relapse which is commonly associated with noncompliance of medicine, as well as stress and high expressed emotions. The objective of the study was to determine the factors of relapse among the schizophrenic patients attending in outpatient departments of three tertiary level psychiatric facilities in Bangladesh. This was a cross sectional study conducted from July, 2001 to June, 2002. Two hundred patients including both relapse and nonrelapse cases of schizophrenia and their key relatives were included by purposive sampling. The results showed no statistically significant difference in terms of relapse with age, sex, religion, residence, occupation and level of education (p>0.05), but statistically significant difference was found with marital status and economic status (p<0.01). The proportion of non-compliance was found to be 80% and 14%, of high expressed emotion was 17% and 2% and of the occurrence of stressful life events was 10% and 1% in relapse and non-relapse cases respectively which were statistically significant (p<0.001). The study indicated that stressful life events, high expressed emotion, and noncompliance with medication had a role in schizophrenic patients for its relapse.Bang J Psychiatry December 2015; 29(2): 59-63

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