Evaluation of expressed emotion in schizophrenia: a comparison of Caucasians and Mexican-Americans.
Social desirability, while a recognized source of respondent bias among Mexican-Americans, has not been evaluated as an explanation for the lower rate of high expressed emotion (EE) found in the family members of Mexican-Americans versus Caucasians with schizophrenia. In this study, we tested the hypothesis that the lower rate of high EE (hostility and criticism) among Mexican-Americans was the result of cultural factors impacting on how information was reported by the Mexican-American relative of a patient with schizophrenia. We compared the ratings of EE between Caucasian (N = 17) and Mexican-American (N = 44) patients with schizophrenia or schizoaffective disorder and their key relatives using the level of expressed emotion (LEE) scale (paper and pencil instrument rated by the patient and relative separately) and the Five Minute Speech Sample (observational experimenter rated). The ability of the various measures to predict relapse over two years was also examined. Contrary to our hypothesis, there were no differences between patient and family measures within ethnic group. Mexican-American patients and relatives reported lower rates of high EE than Caucasians across all measures. High EE predicted relapse across measures for Caucasian participants, but did not predict relapse for Mexican-Americans on any of the measurement instruments. We discuss the implications of these findings on cross-cultural research and family interventions for individuals with psychotic disorders.
Kopelowicz
Alex
A
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA. akopel@ucla.edu
Zarate
Roberto
R
Gonzalez
Veronica
V
Lopez
Steven R
SR
Ortega
Paula
P
Obregon
Nora
N
Mintz
Jim
J
D000328:Adult; D017028:Caregivers / Q000523:psychology; D003431:Cross-Cultural Comparison; D019260:Expressed Emotion; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000208:ethnology*; D012565:Schizophrenic Psychology; D012928:Social Desirability; D014342:Truth Disclosure; D044465:White People / Q000523:psychology*