Nonreligious coping and religious coping as predictors of expressed emotion in relatives of patients with schizophrenia.

Expressed emotion (EE) is a measure of the amount of criticism and emotional over involvement expressed by a key relative towards a relative with a disorder or illness (Hooley, 2007). Research has established that living in a high EE environment, which is characterized by increased levels of critical and emotionally exaggerated communication, leads to a poorer prognosis for patients with a mental illness when compared to low EE environments. Despite evidence that EE is a strong predictor of course of illness, there continue to be questions concerning why some family members express excessive levels of high EE attitudes about their mentally ill relatives while others do not. Based on indirect evidence from previous research, the current study tested whether religious and nonreligious coping serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed an EE interview, along with questionnaires assessing situational nonreligious coping and religious coping. In line with hypotheses, results indicated that nonreligious coping predicted EE. Specifically, less use of adaptive emotion-focused coping predicted high EE. Also consistent with predictions, maladaptive religious coping predicted high EE above and beyond nonreligious coping.