Faculty Articles

Title

Caregiver Expressed Emotion and Psychiatric Symptoms in African-Americans with Schizophrenia: An Attempt to Understand the Paradoxical Relationship.

Document Type

Article

Publication Date

6-1-2017

Keywords

Adult, Affect, African Americans, Caregivers, Communication, Expressed Emotion, Family, Female, Hostility, Humans, Interpersonal Relations, Male, Middle Aged, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Surveys and Questionnaires, Symptom Assessment

Publication Title

Family process

ISSN

1545-5300

Volume

56

Issue/No.

2

Abstract

Expressed emotion (EE) is a family environmental construct that assesses how much criticism, hostility, and/or emotional over-involvement a family member expresses about a patient (Hooley, Annual Review of Clinical Psychology, 2007, 3, 329). Having high levels of EE within the family environment has generally been associated with poorer patient outcomes for schizophrenia and a range of other disorders. Paradoxically, for African-American patients, high-EE may be associated with a better symptom course (Rosenfarb, Bellack, & Aziz, Journal of Abnormal Psychology, 2006, 115, 112). However, this finding is in need of additional support and, if confirmed, clarification. In line with previous research, using a sample of 30 patients with schizophrenia and their primary caregivers, we hypothesized that having a caregiver classified as low-EE would be associated with greater patient symptom severity. We also aimed to better understand why this pattern may exist by examining the content of interviews taken from the Five-Minute Speech Sample. Results supported study hypotheses. In line with Rosenfarb et al. (2006), having a low-EE caregiver was associated with greater symptom severity in African-American patients. A content analysis uncovered some interesting patterns that may help elucidate this finding. Results of this study suggest that attempts to lower high-EE in African Americans may, in fact, be counterproductive.

DOI

https://doi.org/10.1111/famp.12188

PubMed ID

26498273

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