Expressed emotion, human agency, and schizophrenia: toward a new model for the EE-relapse association.
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.
Breitborde
Nicholas J K
NJ
Department of Psychiatry, Yale University, New Haven, CT 06519, USA. nicholas.breitborde@yale.edu
López
Steven R
SR
Nuechterlein
Keith H
KH
D017028:Caregivers / Q000523:psychology; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D033262:Narration; D012008:Recurrence; D012565:Schizophrenic Psychology