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Expressed Emotion

The most critical balance to maintain for family members of a schizophrenic patient is emotion. Like other coping skills, patient's family can play an important role reducing the frequency of psychotic symptom relapse. When combined with antipsychotic medication, family programs have been demonstrated to reduce relapse rates in schizophrenia. One approach to the family helping the patient is through psychoeducational family interventions that deal with such topics as encouraging the patient to take medication.


Many of the first studies to use a family intervention approach were focused on the effects of expressed emotion. Expressed emotion is a measure of the attitude expressed by family members when talking about the person whose behavior is disturbed. The pis attached here describes the categories of expressed emotion that are measured. While warmth & positive remarks from family members have positive effect on patients, critical comments, hostility & emotional over involvement seems to have negative effect.




Researchers have generally found that the patient hospitalized for schizophrenia who were subsequently discharged & returned to families high in negative expressed emotion were not likely to stay out of hospital as long as patients whose families were less critical. Negative expressed emotion includes criticism, hostility & exaggerated emotional response to the illness. Extreme over protectiveness is also a negative sign of expressed emotion. Relatives who were rated high in negative expressed emotion made remarks like, " I just tend to let it go because I know when she wants to speak, she will speak."


Research on expressed emotion has become a focus of controversy, because some practitioners & family members believe that it blames families for development of a schizophrenic family member. The research should not be thought of this way. It's focused not on the cause of schizophrenia, but on conditions that increase the chance of rehospitalization. The term expressed emotion became associated with a negative interactive style because early work showed how negative aspects of expressed emotion predicted a high relapse rate.


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