BACKGROUND: The factors influencing the development of expressed emotion (EE) are still unclear. Understanding the carer and patient appraisals operating during the initial adaptation to psychosis may help to clarify the early ontogenesis of EE. METHOD: Fifty patients and key carers were followed-up over 9 months and their appraisals of loss and burden were measured in relation to the evolution of high emotional overinvolvement (EOI) and critical (CC) relationships. RESULTS: The appraisal of loss was linked to high EOI but not high CC relationships at baseline. Loss reduced by 9-month follow-up in those changing from high EOI to high CC or low EE. Subjective burden of carers was linked to loss but not to EE status. Patients' and relatives' appraisals of loss were strongly correlated, particularly in high EOI relationships. Longer duration of untreated psychosis was associated with high CC. CONCLUSIONS: The results are consistent with Bowlby's attachment theory, where EOI and coercive criticism may be understood as adaptive reactions to perceived loss. Implications for family intervention in first-episode psychosis and the prevention of high EE are discussed.
BACKGROUND: The factors influencing the development of expressed emotion (EE) are still unclear. Understanding the carer and patient appraisals operating during the initial adaptation to psychosis may help to clarify the early ontogenesis of EE. METHOD: Fifty patients and key carers were followed-up over 9 months and their appraisals of loss and burden were measured in relation to the evolution of high emotional overinvolvement (EOI) and critical (CC) relationships. RESULTS: The appraisal of loss was linked to high EOI but not high CC relationships at baseline. Loss reduced by 9-month follow-up in those changing from high EOI to high CC or low EE. Subjective burden of carers was linked to loss but not to EE status. Patients' and relatives' appraisals of loss were strongly correlated, particularly in high EOI relationships. Longer duration of untreated psychosis was associated with high CC. CONCLUSIONS: The results are consistent with Bowlby's attachment theory, where EOI and coercive criticism may be understood as adaptive reactions to perceived loss. Implications for family intervention in first-episode psychosis and the prevention of high EE are discussed.
Authors: Jens Einar Jansen; Ulrik Helt Haahr; Susanne Harder; Anne Marie Trauelsen; Hanne-Grethe Lyse; Marlene Buch Pedersen; Erik Simonsen Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2014-07-23 Impact factor: 4.328
Authors: Elizabeth Kuipers; Phil Watson; Juliana Onwumere; Paul Bebbington; Graham Dunn; John Weinman; David Fowler; Daniel Freeman; Amy Hardy; Philippa Garety Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2007-02-13 Impact factor: 4.519