Emotional Attitudes and Direct Communication in the Families of Schizophrenics

1986 ◽  
Vol 149 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Angus M. Strachan ◽  
Michael J. Goldstein ◽  
Julian P. Leff ◽  
Carol Burtt ◽  
Jeri A. Doane
Keyword(s):  
Los Angeles ◽  
Family Life ◽  
Expressed Emotion ◽  
Speech Rate ◽  
Direct Interaction ◽  
Direct Communication ◽  
Face To Face ◽  
Schizophrenic Patients

To examine how the measure of expressed emotion relates to family life, 30 relatives of schizophrenic patients were assessed for EE and then observed in ten-minute discussions with the patients. It was found that high-EE relatives express more negative emotional statements than low-EE relatives when face-to-face with the patient; they also talk more rapidly, and this speech rate is correlated with the patient speech rate. Whereas low-EE relatives expressed few criticisms or intrusive statements, high-EE over-involved relatives were more intrusive, and high-EE critical relatives were more critical as well as more intrusive in direct interaction. These findings emphasise the importance of understanding divergent EE sub-styles and the complementary behaviour of patients. The findings of an earlier Los Angeles study were replicated.

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.

A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients: Two Year Follow-up

1985 ◽  
Vol 146 (6) ◽  
pp. 594-600 ◽  
Author(s):  
Julian Leff ◽  
Liz Kuipers ◽  
Ruth Berkowitz ◽  
David Sturgeon
Keyword(s):  
Relapse Rate ◽  
Antipsychotic Medication ◽  
Expressed Emotion ◽  
Controlled Trial ◽  
Social Contact ◽  
Social Intervention ◽  
Face To Face ◽  
The Social ◽  
Schizophrenic Patients

SummaryThe two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14%, compared with 78% for control patients on regular medication (P = 0.02).

Interactional Correlates of Expressed Emotion in the Families of Schizophrenics

1984 ◽  
Vol 144 (5) ◽  
pp. 482-487 ◽  
Author(s):  
David J. Miklowitz ◽  
Michael J. Goldstein ◽  
Ian R. H. Falloon ◽  
Jeri A. Doane
Keyword(s):  
Construct Validity ◽  
Expressed Emotion ◽  
Direct Interaction ◽  
Affective Communication ◽  
Verbal Behaviour ◽  
Schizophrenic Patients

SummaryMeasures of intrafamilial expressed emotion (EE) predict relapse in schizophrenic patients, but previous research has not investigated whether EE scores are representative of ongoing family transactions. Parents of 42 hospitalized schizophrenic patients were rated for level and type of EE. Following the patient's discharge, families participated in two 10-minute direct interaction tasks. Transcripts from these interactions were coded on dimensions of affective communication.High-EE parents exhibited more negatively charged emotional verbal behaviour in direct transaction with their schizophrenic offspring than did low-EE parents. Some parents rated high-EE were distinguished by their frequent usage of critical comments during the interactions, whereas high-EE overinvolved parents used more intrusive, invasive statements. These findings support the construct validity of expressed emotion.

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 Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989909
Author(s):  
Eric Apaydin
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Primary Care Physicians ◽  
Theory Approach ◽  
Structured Interviews ◽  
Job Roles ◽  
Face To Face ◽  
Administrative Work ◽  
Job Role ◽  
The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

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

scholarly journals Time-Space Flexibility and Work: Analyzing the “Anywhere and Anytime Office” in the Entertainment, New Media, and Arts Sector

2013 ◽  
Vol 5 (3) ◽  
pp. 339-360
Author(s):  
Leila Valoura
Keyword(s):  
Los Angeles ◽  
New Media ◽  
Material Culture ◽  
Family Life ◽  
Cultural Analysis ◽  
Academic Knowledge ◽  
Time Space ◽  
Work At Home ◽  
Time Diaries ◽  
At Home

The applied cultural analysis work presented in this article was conducted with independent professionals who work in a flexible time-space format – known as telework – for the entertainment, new media, and arts sector in the Los Angeles area. Most participants are associates of the production and post-production boutique “Studio Can” as well as the curatorial new media and arts nonprofit organization “PalMarte.” When working in a flexible time-space format, boundaries between leisure/family life and work at home, or personal and public realms, tend to become blurred. This blurred context involves a web of cultural complexity that exists behind the materialization of boundaries. Through empirical material, this article examines rhythms and mechanisms between flexibility and stability, unveiling a viscous consistency of everyday life. This work helps to better understand the relation between leisure/family life and work at home, as well as stability and change, to rethink these realms and how they relate to each other but also how they transform one another. Although culturally different, these realms are bridged through the material culture that surrounds them. As conveyors, objects (such as a heating pad) and activities culturally transport participants between realms. Research methods combined time-diaries, interviews, observation, visual ethnography, and autoethnography. While applying academic knowledge into a non-academic setting to rethink realms and how they relate and transform each other in a bridged relationship, this work is also an invitation to rethink the relationship between the realms of academia and non-academia.

Family Management Programmes for Schizophrenic Patients

1989 ◽  
Vol 155 (S5) ◽  
pp. 112-116 ◽  
Author(s):  
Kurt Hahlweg ◽  
Eli Feinstein ◽  
Ursula Müller ◽  
Matthias Dose
Keyword(s):  
Expressed Emotion ◽  
Causal Role ◽  
Family Management ◽  
New Techniques ◽  
Schizophrenic Psychosis ◽  
Schizophrenic Patients ◽  
Family Variables ◽  
Relationship Of ◽  
The Relationship

Hypotheses on the relationship of schizophrenia and family variables have changed considerably over the last 15 years: whereas speculations on the causal role of familial interaction for the onset of schizophrenic psychosis previously dominated the field of psychological theorising and psychotherapy (Bateson et al, 1956), it was not possible to confirm these theories empirically. In accordance with the research on Expressed Emotion (EE), a shift in emphasis to the influence of family variables on the further course of the illness has taken place. As a consequence, promising new techniques have been developed for the prevention or postponement of relapse.

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