Expressed Emotion, Human Agency, and Schizophrenia: Toward a New Model for the EE-Relapse Association
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- Breitborde, N.J.K., López, S.R. & Nuechterlein, K.H. Cult Med Psychiatry (2009) 33: 41. doi:10.1007/s11013-008-9119-x
Although there is a clear statistical association between expressed emotion (EE) and schizophrenic relapse, our understanding of the mechanisms underlying this relationship is underdeveloped. This study tested a theoretical model in which caregivers’ perceptions of their ill relative’s agency underlie the EE-relapse association. To evaluate this model, we completed qualitative and quantitative analyses of narratives provided by individuals caring for a relative with schizophrenia. The results indicate that high-EE caregivers perceive the expression of symptoms as stemming from their ill relative’s agency more frequently than low-EE caregivers. This was true for both high-EE-criticism and high-EE-emotional overinvolvement caregivers. High-EE and low-EE caregivers did not differ in their perceptions of the role of their ill relative’s agency with regard to the control of symptoms. The findings suggest that EE may be a proxy risk factor for caregivers’ perceptions of their ill relative’s agency.