Expressed emotion Sample Clauses

Expressed emotion. The family environment of a person with psychosis has been extensively measured using the concept of expressed emotion (EE). The methodology associated with this concept was initially used to investigate and describe the effects of different social environments after individuals with psychosis returned home from inpatient admissions (▇▇▇▇▇ & ▇▇▇▇▇▇, 1996). In EE, the emotional aspects of close relationships are measured using prosodic variables, pitch, tone and emphasis (▇▇▇▇▇▇▇, 1979). EE measures key aspects of interpersonal relationships including criticism, hostility, warmth, positive comments, and emotional over-involvement (▇▇▇▇▇▇▇, Tarrier, Barrowclough, Zastowny, & ▇▇▇▇▇▇, 2000). Carers can be classified as being either high or low on EE. Carers described as high in EE typically express above threshold levels of critical, hostile and/or emotionally over-involved behaviours towards the individual with psychosis. Conversely, those below the threshold are rated as low EE. High EE in carers has been found to be a robust predictor of relapse in individuals with psychosis (▇▇▇▇▇▇▇▇▇▇ & ▇▇▇▇▇▇▇, 1994; ▇▇▇▇▇▇▇▇ & ▇▇▇▇▇▇, 1998). In a meta-analysis of 25 worldwide studies of EE and patient outcomes, individuals returning to live with high EE families after a hospital admission had a 50% relapse rate nine months later, compared with 22% in individuals returning to low EE families (▇▇▇▇▇▇▇▇▇▇ & ▇▇▇▇▇▇▇, 1994). High EE is also predictive of outcome in other health and psychiatric conditions (see ▇▇▇▇▇▇▇ et al., 2000, for a review), such as diabetes (▇▇▇▇▇▇▇, ▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇, & ▇▇▇▇▇▇, 2006) and bipolar affective disorder (▇▇▇ & ▇▇▇▇▇▇▇▇▇, 2004). Given the level of involvement of carers in the care and treatment of service users with psychosis and the importance of EE to patient outcomes, EE remains an important concept to measure and understand.

Expressed emotion. In considering the transmission of psychopathology in families, the construct of expressed emotion (EE) has been particularly important. EE is a method of measuring family members’ responses to an individual and refers to a family member’s expressed criticism, hostility and/or emotional over-involvement (EOI). EE is seen to reflect the emotional quality of interactions between individuals and is a general risk factor for a wide range of psychopathology as well as high maternal EOI showing association with anxiety disorders. Measures of EE are considered to be less prone to bias than self-report in tapping aspects of parenting known to be linked to childhood anxiety, such as an overinvolved or more specifically an overprotective parenting style (▇▇▇▇▇▇▇▇ and ▇▇▇▇▇▇ 1998; ▇▇▇▇▇, ▇▇▇▇▇▇ et al. 2009). Such parenting styles are also associated with withdrawn and inhibited child behaviour (▇▇▇, ▇▇▇▇▇▇▇▇▇ et al. 2005) which can cause the child and parent to fall into a cycle where the inhibited behaviour of a child elicits more protective parenting which leads to the child being more inhibited and so on. This is an important area of research developmentally given that behavioural inhibition may precipitate other forms of psychopathology (▇▇▇▇▇, ▇▇▇▇▇ et al. 1995). Indeed one criticism that can be leveled at much of the EE literature is that it deals at a disorder level rather than examining the more complex effects on children that are relevant to the pathways that may lead to disorder, or phenomena seen in sub-clinical populations. Associations between high EOI and child anxiety disorders have also been found in an epidemiological sample (▇▇▇▇▇▇, ▇▇▇▇▇▇ et al. 1993). Other research has indicated a relationship between child anxiety and critical parenting (▇▇▇, ▇▇▇▇▇▇▇▇▇ et al.