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.

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.

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.

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

scholarly journals Is Audio Visual Method Better than Traditional for Medical Students? - A Better Survey Report

2013 ◽  
Vol 21 (2) ◽  
pp. 60-64 ◽  
Author(s):  
Rukhsana Parvin ◽  
Md Nazmul Haque ◽  
Naser Ahmed ◽  
Reza Ahmad ◽  
Md Imran Ali ◽  
...  
Keyword(s):  
Teaching Methods ◽  
Formal Training ◽  
Delivery Methods ◽  
Medical College ◽  
Teaching Aids ◽  
Survey Report ◽  
Power Point Presentation ◽  
Power Point ◽  
Better Than ◽  
Medical Colleges

Objectives: Different teaching aids are advocated in the medical colleges for delivery of lectures such as power point presentation, blackboard, transparency sheet, overhead projectors, extempore and lecture sheets .The aim of our study was to compare the more acceptable teaching methods between the students of Dhaka Medical College and Enam Medical College. Materials and Methods: Total one hundred students were selected from fourth year in each medical college. They were asked to fill in a fourteen item questionnaire about their perception of five lecture delivery methods. Questionnaire was properly explained. The results were analyzed separately to find out any differences between preferences of teaching methods in both medical colleges. Results: In DMC 50% students preferred traditional blackboard method ,25% PowerPoint presentations, 5% both blackboard and PowerPoint, 16% extempore and 4% lecture sheet .On the other hand, in EMC, 53% mentioned PowerPoint presentation as most acceptable, 38% blackboard, 5% combined blackboard and PowerPoint and 4% extempore. Some important comments were recorded which could be valuable for the medical teachers. Conclusion: The study showed that students of DMC clearly prefer traditional blackboard method rather than other teaching aids, whereas students of EMC prefer PowerPoint presentation. The study does not bring out any evidence based superiority of any lecture delivery method. It appears that any teaching aid can be appropriate and effective if the teachers are properly trained. This highlights the need for formal training in teaching technologies for good presentation and thus motivate the students. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13612 Bangladesh J Medicine 2010; 21: 60-64

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

A Trial of Family Therapy v. a Relatives Group for Schizophrenia

1989 ◽  
Vol 154 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Julian Leff ◽  
Ruth Berkowitz ◽  
Naomi Shavit ◽  
Angus Strachan ◽  
Ilana Glass ◽  
...  
Keyword(s):  
Family Therapy ◽  
Relapse Rate ◽  
Expressed Emotion ◽  
Cost Effective ◽  
Or Education ◽  
Face To Face ◽  
Social Interventions ◽  
The Family ◽  
Schizophrenic Patients ◽  
Therapy Sessions

Schizophrenic patients living in high contact with relatives having high expressed emotion (EE) were recruited for a trial of social interventions. The patients were maintained on neuroleptic medication, while their families were randomly assigned to education plus family therapy or education plus a relatives group. Eleven out of 12 families accepted family therapy in the home, whereas only six out of 11 families were compliant with the relatives group. Non-compliance was associated with a poorer outcome for the patients in terms of the relapse rate. The relapse rate over nine months in the family therapy stream was 8%, while that in compliant families in the relatives group stream was 17%. Patients' social functioning showed small, non-significant, gains. The data from the current trial were compared with data from a previous trial. The lowering of the relapse rate in schizophrenia appears to be mediated by reductions in relatives' EE and/or face-to-face contact, and is not explained by better compliance with medication. Reduction in EE and/or contact was associated with a minuscule relapse rate (5%). Very little change occurred in families who were non-compliant with the relatives group. On the basis of these findings, we recommend that the most cost-effective procedure is to establish relatives groups in conjunction with family education and one or more initial family therapy sessions in the home. It is particularly important to offer home visits to families who are unable to or refuse to attend the relatives groups.

Sign in / Sign up

Export Citation Format

Share Document