Summary
Comparison of the needs and characteristics of relatives classified as high and low expressed emotion (EE) across a range of measures including social functioning and indices of stress and family burden revealed that high EE relatives reported higher levels of disturbed behaviour, subjective burden, and perceived themselves as coping less effectively. Individuals from high-EE households were more impaired in terms of social functioning, particularly in terms of independence and interpersonal functioning. No difference in overall knowledge about schizophrenia was observed between high and low EE relatives, although high EE relatives possessed more information about hospital procedures. Analysis of needs assessment data, based on a normative approach to need, revealed that two-thirds of high EE relatives, as against one-third of low EE relatives had high needs in at least one or more of the following five areas: knowledge about schizophrenia, subjective burden, personal stress, behavioural disturbance and perceived coping. No low EE relative had high needs on all five criteria. The implications of the results for the meaning and genesis of EE and for service provision are considered.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson C, Hogarty G, Bayer T, et al. (1984) Expressed Emotion and social networks of schizophrenic patients. Br J Psychiatry 144: 247–255
Barrelet L, Ferrero F, Szigethy C, Giddey C, Peluzzer G (1990) Expressed emotion and first admission schizophrenia. Nine month follow-up in a French cultural environment. Br J Psychiatry 156: 357–363
Barrowclough C, Tarrier N (1990) Social functioning in schizophrenic patients: I. The effects of Expressed Emotion and family intervention. Soc Psychiatry Psychiatr Epidemiol 25: 125–129
Birchwood MJ (1992) Familial factors in psychiatry. Curr Opin Psychiatry 5: 295–299
Birchwood M, Cochrane R (1990) Families coping with schizoparenia: coping styles, their origins and correlates. Psychol Med 20: 857–865
Birchwood M, Smith J (1987) Schizophrenia In: Orford J (ed) Coping with disorder in the family. Croom Helm, London, pp 7–38
Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S (1990) The social functioning scale: the development and validation of scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry 157: 853–859
Birchwood M, Smith J, Cochrane R (1992) Specific and non-specific effects of education about schizophrenia: a comparison of three methods. Br J Psychiatry 160: 806–814
Bradshaw J (1972) A taxonomy of social need. In: McLachlan G (ed) Problems and progress in medical care, seventh series. Oxford University Press, London, pp 71–82
Brown GW, Birley JLT, Wing JK (1972) The influence of family life on the course of schizophrenic disorders: a replication. Br J Psychiatry 121: 241–258
Cochrane R (1980) A comparison of the Symptom Rating Test and the Langner 22 item scale for use in epidemological surveys. Psychol Med 10: 115–125
Falloon IRH, Boyd JL, McGill CW, Ranzani J, Moss HB, Gilderman AM (1982) Family management in the prevention of exacerbation of schizophrenia. A controlled study. N Engl J Med 306: 1437–1440
Glynn SM, Pugh R, Rose G (1990) Predictors of relatives' attendance at a state hospital workshop on schizophrenia. Hosp Community Psychiatry 41:67–70
Hahlweg K, Neuchterlein K, Goldstein M, Magana A, Doane J, Snyder K (1987) Parental Expressed Emotion, attitudes and intrafamilial communication behaviour. In: Hahlweg K, Goldstein M (eds) Understanding major mental disorder. The contribution of family interaction research. Family Process Press, New York, pp 8–21
Hatfield AB (1978) Psychological costs of schizophrenia to the family. Soc Work 25:355–359
Hogarty GE, Anderson C, Reiss D, Komblith S, Greenwald D, Javna C, Madonia M (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the after care treatment of schizophrenia. I: One year effects of a controlled study on relapse and expressed emotion. Arch Gen Psychiatry 43:633–642
Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Ulrich R, Carter M (1991) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two year effects of a controlled study on relapse and adjustment. Arch Gen Psychiatry 48:340–347
Kanter J, Lamb R, Loeper C (1987) Expressed Emotion in families: a critical review. Hosp Community Psychiatry 38:374–380
Kuipers L, Bebbington P (1988) Expressed Emotion research in schizophrenia: theoretical and clinical implications. Psychol Med 18:893–909
Leff JP, Vaughn CE (1985) Expressed Emotion in families. Guildford, New York
Leff JP, Berkowitz R, Shavit N, Strachau A, Glass I, Vaughn C (1990) A trial of family therapy vs a relatives group for schizophrenia: a two year follow-up. Br J Psychiatr 157:571–577
MacMillan J, Gold A, Crow T, Johnson A, Johnstone E (1986) The Northwick Prak study of first episodes of schizophrenia: Expressed Emotion and relapse. Br J Psychiatry 148:133–143
Pasamanick B, Scarpitti P, Dinitz S (1967) Schizophrenia in the community. Appleton-Century-Crofts, New York
Smith J, Birchwood M (1987) Specific and non-specific effects of educational intervention with families living with a schizophrenic relative. Br J Psychiatry 150:645–652
Smith J, Birchwood M (1990) Relatives and patients as partners in the management of schizophrenia: The development of a service model. Br J Psychiatry 156:654–660
Tarrier N, Barrowclough C, Vaughn C, Bamrah JS, Poreeddu K Watts S, Freeman HL (1988) The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse. Br J Psychiatry 153:532–542
Vaughn C (1986) Patterns of emotional response in the families of schizophrenic patients. In: Goldstein M, Hand I, Hahlweg K (eds) Treatment of schizophrenia: Family assessment and intervention. Springer, Berlin Heidelberg New York, pp 36–57
Vaughn C, Leff J (1976b) The measurement of Expressed Emotion in families of psychiatric patients. Br J Soc Clin Psychol 15:157–165
Wing J, Cooper J, Sartorius N (1974) Measurement and classification of psychiatric symptoms. Cambridge University Press, Cambridge
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Smith, J., Birchwood, M., Cochrane, R. et al. The needs of high and low expressed emotion families: a normative approach. Soc Psychiatry Psychiatr Epidemiol 28, 11–16 (1993). https://doi.org/10.1007/BF00797827
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00797827