Advertisement

Cognitive-Behavioral Family Interventions in Psychosis

  • Juliana Onwumere
  • Elizabeth Kuipers
Chapter

Abstract

Neurobiological models of psychosis (Garety et al. 2007) alongside cognitive models of caregiving (Kuipers et al. 2010) postulate a key role for families in a patient’s environment. Families can help us to extend our understanding of psychosis and patient outcomes. Given the complexity of psychosis, illness-related difficulties such as disorders of thought and apathy can often interrupt and adversely affect normal patterns of communication between family members. In turn, this may have a negative impact on relationships. Thus, developing optimal communication styles between family members remains an important consideration for service providers.

Keywords

Service User Express Emotion Family Intervention Borderline Personality Disorder Carer Burden 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Addington, J., & Burnett, P. (2004). Working with families in the early stages of psychosis. In J. F. M. Gleeson & P. D. McGorry (Eds.), Psychological interventions for early psychosis. Chichester, UK: Wiley and Sons.Google Scholar
  2. Addington, J., Coldham, E. L., Jones, B., Ko, T., & Addington, D. (2003). The first episode of psychosis: The experience of relatives. Acta Psychiatrica Scandinavica, 108(4), 285–289.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association (2004), “Practice guideline for the treatment of patients with schizophrenia” American Journal of Psychiatry 161(2suppl) pp. 1–56.Google Scholar
  4. Askey, R., Holmshaw, J., Gamble, C., & Gray, R. (2009). What do carers of people with psychosis need from mental health services? Exploring the views of carers, service users and professionals. Journal of Family Therapy, 31, 310–331.CrossRefGoogle Scholar
  5. Awad, A. G., & Voruganti, L. N. P. (2008). The burden of schizophrenia on caregivers – A review. Pharmacoeconomics, 26(2), 149–162.PubMedCrossRefGoogle Scholar
  6. Bachmann, S., Bottmer, C., Jacob, S., & Schroder, J. (2006). Perceived criticism in schizophrenia: A comparison of instruments for the assessment of the patient’s perspective and its relation to relatives’ expressed emotion. Psychiatry Research, 142(2–3), 167–175.PubMedCrossRefGoogle Scholar
  7. Barrowclough, C., Gregg, L., & Tarrier, N. (2008). Expressed emotion and causal attributions in relatives of post-traumatic stress disorder patients. Behaviour Research and Therapy, 46(2), 207–218.PubMedCrossRefGoogle Scholar
  8. Barrowclough, C., & Hooley, J. M. (2003). Attributions and expressed emotion: A review. Clinical Psychology Review, 23(6), 849–880.PubMedCrossRefGoogle Scholar
  9. Barrowclough, C., Johnston, M., & Tarrier, N. (1994). Attributions, expressed emotion, and patient relapse – An attributional model of relatives’ response to schizophrenic illness. Behavior Therapy, 25(1), 67–88.CrossRefGoogle Scholar
  10. Barrowclough, C., Lobban, F., Hatton, C., & Quinn, J. (2001). An investigation of models of illness in carers of schizophrenia patients using the Illness Perception Questionnaire. British Journal of Clinical Psychology, 40, 371–385.PubMedCrossRefGoogle Scholar
  11. Barrowclough, C., & Tarrier, N. (1992). Families of schizophrenic patients: Cognitive behavioural intervention. London: Chapman and Hall.Google Scholar
  12. Barrowclough, C., Tarrier, N., Lewis, S., Sellwood, W., Mainwaring, J., Quinn, J., et al. (1999). Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia. British Journal of Psychiatry, 174, 505–511.PubMedCrossRefGoogle Scholar
  13. Barton, K., & Jackson, C. (2008). Reducing symptoms of trauma among carers of people with psychosis: Pilot study examining the impact of writing about caregiving experiences. Australian and New Zealand Journal of Psychiatry, 42(8), 693–701.PubMedCrossRefGoogle Scholar
  14. Bebbington, P., & Kuipers, L. (1994). The predictive utility of expressed emotion in schizophrenia – An aggregate analysis. Psychological Medicine, 24(3), 707–718.PubMedCrossRefGoogle Scholar
  15. Bergner, E., Leiner, A. S., Carter, T., Franz, L., Thompson, N. J., & Compton, M. T. (2008). The period of untreated psychosis before treatment initiation: A qualitative study of family members’ perspectives. Comprehensive Psychiatry, 49(6), 530–536.PubMedCrossRefGoogle Scholar
  16. Berkowitz, R., Kuipers, L., Eberlein-Vries, R., & Leff, J. (1981). Lowering expressed emotion in relatives of schizophrenics. In M. J. Goldstein (Ed.), New developments in interventions with families of schizophrenics (pp. 27–48). San Francisco: Jossey-Bass.Google Scholar
  17. Berry, K., Wearden, A., & Barrowclough, C. (2007). Adult attachment styles and psychosis: An investigation of associations between general attachment styles and attachment relationships with specific others. Social Psychiatry and Psychiatric Epidemiology, 42, 972–976.PubMedCrossRefGoogle Scholar
  18. Bertrando, P., Beltz, J., Bressi, C., Clerici, M., Farma, T., Invernizzi, G., et al. (1992). Expressed emotion and schizophrenia in Italy – A study of an urban-population. British Journal of Psychiatry, 161, 223–229.PubMedCrossRefGoogle Scholar
  19. Birchwood, M., & Cochrane, R. (1990). Families coping with schizophrenia – Coping styles, their origins and correlates. Psychological Medicine, 20(4), 857–865.PubMedCrossRefGoogle Scholar
  20. Boye, B., & Malt, U. F. (2002). Stress response symptoms in relatives of acutely admitted psychotic patients: A pilot study. Nordic Journal of Psychiatry, 56, 253–260.PubMedCrossRefGoogle Scholar
  21. Brekke, J. S., Prindle, C., Bae, S. W., & Long, J. D. (2001). Risks for individuals with schizophrenia who are living in the community. Psychiatric Services, 52(10), 1358–1366.PubMedCrossRefGoogle Scholar
  22. Brown, G. W. (1959). Experiences of discharged chronic schizophrenic mental hospital patients in various types of living group. Milbank Q, 37, 105–131.Google Scholar
  23. Brown, G. W., Birley, J. L. T., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121(3), 241–258.PubMedCrossRefGoogle Scholar
  24. Brown, S., & Birtwistle, J. (1998). People with schizophrenia and their families – Fifteen-year outcome. British Journal of Psychiatry, 173, 139–144.PubMedCrossRefGoogle Scholar
  25. Brown, G. W., Carstairs, G. M., & Topping, G. (1958). Post-hospital adjustment of chronic mental patients. Lancet, 272(7048), 685–689.CrossRefGoogle Scholar
  26. Brown, G. W., Monck, E. M., Carstairs, G. M., & Wing, J. K. (1962). The influence of family life on the course of schizophrenic illness. British Journal of Preventive Social Medicine, 16(2), 55–68.Google Scholar
  27. Butzlaff, R. L., & Hooley, J. M. (1998). Expressed emotion and psychiatric relapse – A meta-analysis. Archives of General Psychiatry, 55(6), 547–552.PubMedCrossRefGoogle Scholar
  28. Chwastiak, L. A., Rosenheck, R. A., Mcevoy, J. P., Keefe, R. S., Swartz, M. S., & Lieberman, J. A.(2006). Interrelationships of psychiatric symptom severity, medical comorbidity, and functioning in schizophrenia. Psychiatric Services, 57(8), 1102–1109.PubMedCrossRefGoogle Scholar
  29. Cutting, L. P., Aakre, J., & Docherty, N. M. (2006). Schizophrenia patients’ perceptions of stress, expressed emotion attitudes, and sensitivity to criticism. Schizophrenia Bulletin, 32, 743–750.PubMedCrossRefGoogle Scholar
  30. Dixon, L., McFarlane, W.R., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., Mueser, K., Miklowitz, D., Solomon, P., & Sondheimer, D. (2001). Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatric Services 52(7), 903–910.Google Scholar
  31. Docherty, N. M., De Rosa, M., & Andreasen, N. C. (1996). Communication disturbances in schizophrenia and mania. Archives of General of Psychiatry, 53, 358–364.Google Scholar
  32. Docherty, N.M. & Hebert A.S. (1997). Comparative affective reactivity of different types of communication disturbances in schizophrenia. Journal of Abnormal Psychology, 106, 325–330.Google Scholar
  33. Docherty, N. M., Hall, M. J., & Gordinier, S. W. (1998). Affective reactivity of speech in schizophrenia patients and their nonschizophrenic relatives. Journal of Abnormal Psychology, 107, 461–467.PubMedCrossRefGoogle Scholar
  34. Docherty, N.M., Rhinewine, J.P., Labhart, R.P., & Gordinier, S.W. (1998a). Communication disturbances and family psychiatric history in parents of schizophrenic patients. Journal of Nervous and Mental Disease, 186(12), 761–768.Google Scholar
  35. Docherty, N. M., Hall, M. J., & Gordinier, S. W. (1998b). Affective reactivity of speech in schizophrenia patients and their nonschizophrenic relatives. Journal of Abnormal Psychology, 107, 461–467.Google Scholar
  36. Docherty, N. M., Gordinier, S. W., Hall, M. J., & Dombrowski, M. E. (2004). Referential communication disturbances in the speech of nonschizophrenic siblings of schizophrenia patients. Journal of Abnormal Psychology, 113(3), 399–405.PubMedCrossRefGoogle Scholar
  37. Docherty, N. M., Rhinewine, J. P., Labhart, R. P., & Gordinier, S. W. (1998). Communication disturbances and family psychiatric history in parents of schizophrenic patients. Journal of Nervous and Mental Disease, 186(12), 761–768.PubMedCrossRefGoogle Scholar
  38. Dyck, D. G., Short, R., & Vitaliano, P. P. (1999). Predictors of burden and infectious illness in schizophrenia caregivers. Psychosomatic Medicine, 61, 411–419.PubMedGoogle Scholar
  39. Fadden, G. (2006). Training and disseminating family interventions for schizophrenia: Developing family intervention skills with multi-disciplinary groups. Journal of Family Therapy, 28(1), 23–38.CrossRefGoogle Scholar
  40. Falloon, I.R.H. (2003). Family interventions for mental disorders: efficacy and effectiveness. World Psychiatry 2(1).Google Scholar
  41. Falloon, I. R. H., Boyd, J. L., & McGill, C. W. (1984). Family care of schizophrenia. New York: Guildford Press.Google Scholar
  42. Fialko, L., Freeman, D., Bebbington, P. E., Kuipers, E., Garety, P. A., Dunn, G., et al. (2006). Understanding suicidal ideation in psychosis: Findings from the Psychological Prevention of Relapse in Psychosis (PRP) trial. Acta Psychiatrica Scandinavica, 114(3), 177–186.PubMedCrossRefGoogle Scholar
  43. Fisher, H., Theodore, K., Power, P., Chisholm, B., Fuller, J., Marlowe, K., Aitchison, K. J., Tanna, R., Joyce, J., Sacks, M., Craig, T., & Johnson, S. (2008), “Routine evaluation in first episode psychosis services: feasibility and results from the MiData project”, Social Psychiatry and Psychiatric Epidemiology, vol. 43, no.12, pp. 960–967.Google Scholar
  44. Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21(3), 219–239.PubMedCrossRefGoogle Scholar
  45. Friedrich, R. M., Lively, S., & Rubenstein, L. M. (2008). Siblings’ coping strategies and mental health services: A national study of siblings of persons with schizophrenia. Psychiatric Services, 59(3), 261–267.PubMedCrossRefGoogle Scholar
  46. Garcia, J.I.R., Chang, C.L., Young, J.S., Lopez, S.R., & Jenkins, J.H. (2006), “Family support predicts psychiatric medication usage among Mexican American individuals with schizophrenia” Social Psychiatry and Psychiatric Epidemiology, 41(8), pp. 624–631.Google Scholar
  47. Garety, P. A., Bebbington, P., Fowler, D., Freeman, D., & Kuipers, E. (2007). Implications for neurobiological research of cognitive models of psychosis: A theoretical paper. Psychological Medicine, 37(10), 1377–1391.PubMedCrossRefGoogle Scholar
  48. Garety, P. A., Fowler, D. G., Freeman, D., Bebbington, P., Dunn, G., & Kuipers, E. (2008). Cognitive behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: Randomised controlled trial. British Journal of Psychiatry, 192, 412–423.PubMedCrossRefGoogle Scholar
  49. Goldstein, M. J., & Strachan, A. M. (1987). The family and schizophrenia. In T. Jacob (Ed.), Family interaction and psychopathology: Theories, methods and findings (pp. 481–508). New York: Plenum Press.Google Scholar
  50. Grandon, P., Jenaro, C., & Lemos, S. (2008). Primary caregivers of schizophrenia outpatients: Burden and predictor variables. Psychiatry Research, 158(3), 335–343.PubMedCrossRefGoogle Scholar
  51. Greenberg, J. S., Seltzer, M. M., Hong, J., & Orsmond, G. I. (2006). Bidirectional effects of expressed emotion and behaviour problems and symptoms in adolescents and adults with autism. American Journal on Mental Retardation, 11(4), 229–249.CrossRefGoogle Scholar
  52. Grice, S. J., Kuipers, E., Bebbington, P., Dunn, G., Fowler, D., Freeman, D., et al. (2009). Carers’ attributions about positive events in psychosis relate to expressed emotion. Behaviour Research and Therapy, 47(9), 783–789.PubMedCrossRefGoogle Scholar
  53. Harrison, C. A., & Dadds, M. R. (1992). Attributions of symptomatology – An exploration of family factors associated with expressed emotion. Australian and New Zealand Journal of Psychiatry, 26(3), 408–416.PubMedCrossRefGoogle Scholar
  54. Harvey, P. D., Weintraub, S., & Neale, J. M. (1982). Speech competence of children vulnerable to psychopathology. Journal of Abnormal Child Psychology, 10, 373–388.PubMedCrossRefGoogle Scholar
  55. Hooley, J. M., & Campbell, C. (2002). Control and controllability: Beliefs and behaviour in high and low expressed emotion relatives. Psychological Medicine, 32(6), 1091–1099.PubMedCrossRefGoogle Scholar
  56. Hooley, J.M., Gruber, S.A., Parker, H.A., Guillaumot, J., Rogowska, J., & Yurgelun-Todd, D.A. (2009). Cortico-limbic response to personally challenging emotional stimuli after complete recovery from depression (vol 171, pg 106, 2009). Psychiatry Research-Neuroimaging 172(1), 82–91.Google Scholar
  57. Hooley, J. M., Gruber, S. A., Scott, L. A., Hiller, J. B., & Yurgelun-Todd, D. A. (2005). Activation in dorsolateral prefrontal cortex in response to maternal criticism and praise in recovered depressed and healthy control participants. Biological Psychiatry, 57(7), 809–812.PubMedCrossRefGoogle Scholar
  58. Hooley, J. M., & Hoffman, P. D. (1999). Expressed emotion and clinical outcome in borderline personality disorder. American Journal of Psychiatry, 156(10), 1557–1562.PubMedGoogle Scholar
  59. Hooley, J. M., Orley, J., & Teasdale, J. D. (1986). Levels of expressed emotion and relapse in depressed-patients. British Journal of Psychiatry, 148, 642–647.PubMedCrossRefGoogle Scholar
  60. Hooley, J. M., & Teasdale, J. D. (1989). Predictors of relapse in unipolar depressives – Expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology, 98(3), 229–235.PubMedCrossRefGoogle Scholar
  61. Jungbauer, J., & Angermeyer, M. C. (2002). Living with a schizophrenic patient: A comparative study of burden as it affects parents and spouses. Psychiatry, 65(2), 110–123.PubMedGoogle Scholar
  62. Jungbauer, J., Wittmund, B., Dietrich, S., & Angermeyer, M. C. (2003). Subjective burden over 12 months in parents of patients with schizophrenia. Archives of Psychiatric Nursing, 17(3), 126–134.PubMedCrossRefGoogle Scholar
  63. Karanci, A. N., & Inandilar, H. (2002). Predictors of components of expressed emotion in major caregivers of Turkish patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 37(2), 80–88.PubMedCrossRefGoogle Scholar
  64. Karp, D. A., & Tanarugsachock, V. (2000). Mental illness, caregiving, and emotion management. Qualitative Health Research, 10(1), 6–25.PubMedCrossRefGoogle Scholar
  65. Kennedy, S. H., Evans, K. R., Kruger, S., Mayberg, H. S., Meyer, J. H., McCann, S., et al. (2001). Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. American Journal of Psychiatry, 158(6), 899–905.PubMedCrossRefGoogle Scholar
  66. Kiecolt-Glaser, J. K., Loving, T. J., Stowell, J. R., Malarkey, W. B., Lemeshow, S., Dickinson, S. L., et al. (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry, 62(12), 1377–1384.PubMedCrossRefGoogle Scholar
  67. Kim, H. W., & Salyers, M. P. (2008). Attiudes and perceived barriers to working with families of persons with severe mental illness: Mental health professionals’ perspectives. Community Mental Health Journal, 44, 337–345. doi:10.1007/s10597-008-9135-x.PubMedCrossRefGoogle Scholar
  68. Kjellin, L., & Ostman, M. (2005). Relatives of psychiatric inpatients – Do physical violence and suicide attempts of patients influence family burden and participation in care? Nordic Journal of Psychiatry, 59(1), 7–11.PubMedCrossRefGoogle Scholar
  69. Kopelowicz, A., Lopez, S. R., Zarate, R., O’Brien, M., Gordon, J., Chang, C., et al. (2006). Expressed emotion and family interactions in Mexican Americans with schizophrenia. Journal of Nervous and Mental Disease, 194(5), 330–334.PubMedCrossRefGoogle Scholar
  70. Kopelowicz, A., Zarate, R., Gonzalez, V., Lopez, S. R., Ortega, P., Obregon, N., et al. (2002). Evaluation of expressed emotion in schizophrenia: A comparison of Caucasians and Mexican-Americans. Schizophrenia Research, 55(1–2), 179–186.PubMedCrossRefGoogle Scholar
  71. Kuipers, E., & Bebbington, P. (2005). Research on burden and coping strategies in families of people with mental disorders: Problems and perspectives. In N. Sartorious, J. Leff, & J. J. Lopez (Eds.), Families and mental disorder: From burden to empowerment (pp. 217–234). Chichester, UK: Wiley.CrossRefGoogle Scholar
  72. Kuipers, E., Leff, J., & Lam, D. (2002). Family work for schizophrenia: A practical guide. London: Gaskell Press.Google Scholar
  73. Kuipers, E., Onwumere, J., & Bebbington, P. (2010). A cognitive model of caregiving in psychosis. British Journal of Psychiatry, 196, 259–265.PubMedCrossRefGoogle Scholar
  74. Kuipers, E., & Raune, D. (2000). The early development of expressed emotion and burden in the families of first onset psychosis. In M. Birchwood, D. Fowler, & C. Jackson (Eds.), Early intervention in psychosis (pp. 128–140). Chichester, UK: John Wiley & Sons.Google Scholar
  75. Kuipers, L., Sturgeon, D., Berkowitz, R., & Leff, J. (1983). Characteristics of expressed emotion – Its relationship to speech and looking in schizophrenic-patients and their relatives. British Journal of Clinical Psychology, 22, 257–264.PubMedGoogle Scholar
  76. Kuipers, E., Watson, P., Onwumere, J., Bebbington, P., Dunn, G., Weinman, J., et al. (2007). Discrepant illness perceptions, affect and expressed emotion: In people with psychosis and their carers. Social Psychiatry and Psychiatric Epidemiology, 42, 277–283.PubMedCrossRefGoogle Scholar
  77. Kymalainen, J. A., Weisman, A. G., Rosales, G. A., & Armesto, J. C. (2006). Ethnicity, expressed emotion, and communication deviance in family members of patients with schizophrenia. Journal of Nervous and Mental Disease, 194(6), 391–396.PubMedCrossRefGoogle Scholar
  78. Lauber, C., Eichenberger, A., Luginbuhl, P., Keller, C., & Rossler, W. (2003). Determinants of burden in caregivers of patients with exacerbating schizophrenia. European Psychiatry, 18(6), 285–289.PubMedCrossRefGoogle Scholar
  79. Lebell, M. B., Marder, S. R., Mintz, J., Mintz, L. I., Tompson, M., Wirshing, W., et al. (1993). Patients’ perceptions of family emotional climate and outcome in schizophrenia. British Journal of Psychiatry, 162, 751–754.PubMedCrossRefGoogle Scholar
  80. Lee, C., & Gramotnev, H. (2007). Transitions into and out of caregiving: Health and social characteristics of mid-age Australian women. Psychology and Health, 22, 193–209.CrossRefGoogle Scholar
  81. Lehman, A. F., Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B., Dixon, L. B., Goldberg, R., et al. (2004). The Schizophrenia Patient Outcomes Research Team (PORT): Updated treatment recommendations 2003. Schizophrenia Bulletin, 30(2), 193–217.PubMedGoogle Scholar
  82. Lin, H. C., Hsiao, F. H., Pfeiffer, S., Hwang, Y. T., & Lee, H. C. (2008). An increased risk of stroke among young schizophrenia patients. Schizophrenia Research, 101(1–3), 234–241.PubMedCrossRefGoogle Scholar
  83. Lobban, F., Barrowclough, C., & Jones, S. (2005). Assessing cognitive representations of mental health problems. II. The illness perception questionnaire for schizophrenia: Relatives’ version. British Journal of Clinical Psychology, 44, 163–179.PubMedCrossRefGoogle Scholar
  84. Lopez, S. R., Hipke, K. N., Polo, A. J., Jenkins, J. H., Karno, M., & Vaughn, C. (2004). Ethnicity, expressed emotion, attributions, and course of schizophrenia: Family warmth matters. Journal of Abnormal Psychology, 113(3), 428–439.PubMedCrossRefGoogle Scholar
  85. Magliano, L., Fadden, G., Economou, M., Held, T., Xavier, M., Guarneri, M., et al. (2000). Family burden and coping strategies in schizophrenia: One-year follow-up data from the BIOMED I study. Social Psychiatry and Psychiatric Epidemiology, 35(3), 109–115.PubMedCrossRefGoogle Scholar
  86. Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., & Maj, M. (2006). Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatric Services, 57(12), 1784–1791.PubMedCrossRefGoogle Scholar
  87. Marom, S., Munitz, H., Jones, P. B., Weizman, A., & Hermesh, H. (2002). Familial expressed emotion: Outcome and course of Israeli patients with schizophrenia. Schizophrenia Bulletin, 28(4), 731–743.PubMedGoogle Scholar
  88. Martens, L., & Addington, J. (2001). The psychological well-being of family members of individuals with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 36(3), 128–133.Google Scholar
  89. McFarlane, W. R. (2002). Multifamily groups in the treatment of severe psychiatric disorders. New York: Guilford Press.Google Scholar
  90. McFarlane, W. R., Lukens, E., Link, B., Dushay, R., Deakins, S. A., Newmark, M., et al. (1995). Multiple-family groups and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry, 52(8), 679–687.PubMedGoogle Scholar
  91. McNab, C., Haslam, N., & Burnett, P. (2007). Expressed emotion, attributions, utility beliefs, and distress in parents of young people with first episode psychosis. Psychiatry Research, 151(1–2), 97–106.PubMedCrossRefGoogle Scholar
  92. Miklowitz, D.J., Goldstein, M.J., Falloon, I.R.H., & Doane, J.A. (1984). Interactional Correlates of Expressed Emotion in the Families of Schizophrenics. British Journal of Psychiatry 144(MAY), 482–487.Google Scholar
  93. Moller-Leimkuhler, A. M. (2005). Burden of relatives and predictors of burden. Baseline results from the Munich 5-year-follow-up study on relatives of first hospitalized patients with schizophrenia or depression. European Archives of Psychiatry and Clinical Neuroscience, 255(4), 223–231.PubMedCrossRefGoogle Scholar
  94. Moller-Leimkuhler, A. M., & Obermeier, M. (2008). Predicting caregiver burden in first admission psychiatric patients. Two-year follow-up results. European Archives of Psychiatry and Clinical Neuroscience, 258, 406–413.PubMedCrossRefGoogle Scholar
  95. Morgan, C., Kirkbride, J., Hutchinson, G., Craig, T., Morgan, K., Dazzan, P., Boydell, J., Doody, G.A., Jones, P.B., Murray, R.M., Leff, J., & Fearon, P. (2008). Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychological Medicine 38(12), 1701–1715.Google Scholar
  96. NICE Schizophrenia Guideline (Update, 2009)Google Scholar
  97. Nordentoft, M., Jeppesen, P., Abel, M., Kassow, P., Petersen, L., Thorup, A., et al. (2002). OPUS study: Suicidal behaviour, suicidal ideation and hopelessness among patients with first-episode psychosis: One-year follow-up of a randomised controlled trial. British Journal of Psychiatry, 181(43), s98–s106.CrossRefGoogle Scholar
  98. Onwumere, J., Kuipers, E., Bebbington, P., Dunn, G., Freeman, D., Fowler, D., et al. (2009). Patient perceptions of caregiver criticism in psychosis: Links with patient and caregiver functioning. Journal of Nervous and Mental Disease, 197(2), 85–91.PubMedCrossRefGoogle Scholar
  99. Osborn, D. P. J., Levy, G., Nazareth, I., Petersen, I., Islam, A., & King, M. B. (2007). Relative risk of cardiovascular and cancer mortality in people with severe mental illness from the United Kingdom’s General Practice Research Database. Archives of General Psychiatry, 64(2), 242–249.PubMedCrossRefGoogle Scholar
  100. Ostman, M., & Hansson, L. (2004). Appraisal of caregiving, burden and psychological distress in relatives of psychiatric inpatients. European Psychiatry, 19(7), 402–407.PubMedCrossRefGoogle Scholar
  101. Oyebode, J. (2003). Assessment of carers’ psychological needs. Advances in Psychiatric Treatment, 9, 45–53.CrossRefGoogle Scholar
  102. Pfammatter, M., Junghan, U. M., & Brenner, H. D. (2006). Efficacy of psychological therapy in schizophrenia: Conclusions from meta-analyses. Schizophrenia Bulletin, 32(Suppl 1), S64–S80.PubMedCrossRefGoogle Scholar
  103. Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2006). Family intervention for schizophrenia. Cochrane Database of Systematic Reviews, 4(4), CD000088. 10.1002/14651858.CD000088.pub2.Google Scholar
  104. Phillips, A. C., Gallagher, S., Hunt, K., Der, G., & Carroll, D. (2009). Symptoms of depression in non-routine caregivers: The role of caregiver strain and burden. British Journal of Clinical Psychology, 48, 335–346.PubMedCrossRefGoogle Scholar
  105. Pilling, S., Bebbington, P., Garety, P., Kuipers, E., Geddes, J., & Martindale, B. (2002). Meta-analysis of psychological treatment in psychosis I: Family work and individual CBT. Psychological Medicine, 32, 763–782.PubMedGoogle Scholar
  106. Quinn, J., Barrowclough, C., & Tarrier, N. (2003). The Family Questionnaire (FQ): a scale for measuring symptom appraisal in relatives of schizophrenic patients. Acta Psychiatrica Scandinavica, 108(4), 290–296.Google Scholar
  107. Raune, D., Kuipers, E., & Bebbington, P. E. (2004). Expressed emotion at first-episode psychosis: Investigating a carer appraisal model. British Journal of Psychiatry, 184(4), 321–326.PubMedCrossRefGoogle Scholar
  108. Rosenfarb, I. S., Goldstein, M. J., Mintz, J., & Nuechterlein, K. H. (1995). Expressed emotion and subclinical psychopathology observable within the transactions between schizophrenic-patients and their family members. Journal of Abnormal Psychology, 104(2), 259–267.PubMedCrossRefGoogle Scholar
  109. Rossler, W., Salize, H. J., van Os, J., & Riecher-Rossler, A. (2005). Size of burden of schizophrenia and psychotic disorders. European Neuropsychopharmacology, 15(4), 399–409.PubMedCrossRefGoogle Scholar
  110. Scazufca, M., & Kuipers, E. (1996). Links between expressed emotion and burden of care in relatives of patients with schizophrenia. British Journal of Psychiatry, 168(5), 580–587.PubMedCrossRefGoogle Scholar
  111. Scazufca, M., & Kuipers, E. (1999). Coping strategies in relatives of people with schizophrenia before and after psychiatric admission. British Journal of Psychiatry, 174(2), 154–158.PubMedCrossRefGoogle Scholar
  112. Scazufca, M., Kuipers, E., & Menezes, P. R. (2001). Perception of negative emotions in close relatives by patients with schizophrenia. British Journal of Clinical Psychology, 40, 167–175.PubMedCrossRefGoogle Scholar
  113. Schomerus, G., Heider, D., Angermeyer, M. C., Bebbington, P. E., Azorin, J. M., Brugha, T., et al. (2008). Urban residence, victimhood and the appraisal of personal safety in people with schizophrenia: Results from the European Schizophrenia Cohort (EuroSC). Psychological Medicine, 38, 591–597.PubMedCrossRefGoogle Scholar
  114. Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: The caregiver health effects study. Journal of the American Medical Association, 282, 2215–2219.PubMedCrossRefGoogle Scholar
  115. Shimodera, S., Mino, Y., Inoue, S., Izumoto, Y., Fujita, H., & Ujihara, H. (2000). Expressed emotion and family distress in relatives of patients with schizophrenia in Japan. Comprehensive Psychiatry, 41(5), 392–397.PubMedCrossRefGoogle Scholar
  116. Simoneau, T. L., Miklowitz, D. J., & Saleem, R. (1998). Expressed emotion and interactional patterns in the families of bipolar patients. Journal of Abnormal Psychology, 107(3), 497–507.PubMedCrossRefGoogle Scholar
  117. Singleton, N., Maung, N., Cowie, A., Sparks, J., Bumpstead, R., & Meltzer, H. (2002). Mental health of carers. London: Office for National Statistics.Google Scholar
  118. Stam, H., & Cuijpers, P. (2001). Effects on family interventions on burden of relatives of psychiatric patients in the Netherlands: A pilot study. Community Mental Health Journal, 37, 179–187.PubMedCrossRefGoogle Scholar
  119. Stoskopf, C. H., Kim, Y. K., & Glover, S. H. (2001). Dual diagnosis: HIV and mental illness, a population-based study. Community Mental Health Journal, 37(6), 469–479.PubMedCrossRefGoogle Scholar
  120. Strachan, M., Leff, J. P., Goldstein, J., Doane, J. A., & Burtt, C. (1986). Emotional attitudes and direct communication in the families of schizophrenics: A cross-national replication. British Journal of Psychiatry, 149, 279–287.PubMedCrossRefGoogle Scholar
  121. Subotnik, K. L., Goldstein, M. J., Nuechterlein, K. H., Woo, S. M., & Mintz, J. (2002). Are communication deviance and expressed emotion related to family history of psychiatric disorders in schizophrenia? Schizophrenia Bulletin, 28(4), 719–729.PubMedGoogle Scholar
  122. Tang, V., Leung, S., & Lam, L. (2008). Clinical correlates of the caregiving experience for Chinese caregivers of patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 43(9), 720–726. DOI 10.1007/s00127-008-0357-6.PubMedCrossRefGoogle Scholar
  123. Tompson, M. C., Goldstein, M. J., Lebell, M. B., Mintz, L. I., Marder, S. R., & Mintz, J. (1995). Schizophrenic-patients perceptions of their relatives’ attitudes. Psychiatry Research, 57(2), 155–167.PubMedCrossRefGoogle Scholar
  124. Ukpong, D. I. (2006). Demographic factors and clinical correlates of burden and distress in relatives of services users experiencing schizophrenia: A study from south-western Nigeria. International Journal of Mental Health Nursing, 15, 54–59.PubMedCrossRefGoogle Scholar
  125. US Surgeon General (1999) A report of the Surgeon General. Rockville: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, National Institutes of Health.Google Scholar
  126. Vaddadi, K., Gilleard, C., & Fryer, H. (2002). Abuse of carers by relatives with severe mental illness. International Journal of Social Psychiatry, 48(2), 149.PubMedCrossRefGoogle Scholar
  127. Weisman, A. G., & Lopez, S. R. (1997). An attributional analysis of emotional reactions to schizophrenia in Mexican and Anglo cultures. Journal of Applied Social Psychology, 27, 224–245.CrossRefGoogle Scholar
  128. Wolthaus, J. E. D., Dingemans, P. M. A. J., Schene, A. H., Linszen, D. H., Wiersma, D., Van den Bosch, R. J., et al. (2002). Caregiver burden in recent-onset schizophrenia and spectrum disorders: The influence of symptoms and personality traits. Journal of Nervous and Mental Disease, 190, 241–247.PubMedCrossRefGoogle Scholar
  129. World Health Organisation (2001). World Health Report. Mental Health: New understanding, New Hope. Geneva, World Health Organisation.Google Scholar
  130. Wuerker, A. K., Haas, G. L., & Bellack, A. S. (2001). Interpersonal control and expressed emotion in families of persons with schizophrenia: Change over time. Schizophrenia Bulletin, 27(4), 671–685.PubMedGoogle Scholar
  131. Yang, L. H., Phillips, M. R., Licht, D. M., & Hooley, J. M. (2004). Causal attributions about schizophrenia in families in China: Expressed emotion and patient relapse. Journal of Abnormal Psychology, 113, 592–602.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of PsychologyKing’s College London, Institute of PsychiatryLondonUK

Personalised recommendations