title: Expressed Emotion in relatives of persons with dementia: a systematic review and meta-analysis.
abstract: Expressed Emotion (EE) refers to a number of key aspects of interpersonal relationships which have been shown to relate to outcomes in relatives of people with health conditions.
  
  
  
  A systematic review and meta-analysis of EE and outcomes in relatives of persons with dementia is reported. Potential research studies were identified via a search of three electronic databases; PsychINFO, MEDLINE and the Web of Science between 1960 and 2015.
  
  
  
  We reviewed 12 studies investigating correlations between EE and well-being in relatives of patients with dementia. Factors hypothesised to influence EE including attributions, social support, coping strategies and relationship quality were also reviewed.
  
  
  
  High-EE relatives were found to have increased levels of burden (Z = 6.967, P < 0.001) and greater levels of depression (Z = 5.842, P < 0.001). Compared to low-EE relatives, high-EE relatives were more likely to attribute the patient's problems to factors that were personal to and controllable by the patient. Relatives with less social support, inefficient coping strategies and a poor relationship with the patients, were more likely to be classified as high-EE.
authors.affiliation: a Department of Clinical Psychology , University of Manchester , Manchester , UK.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Safavi
authors.affiliation: a Department of Clinical Psychology , University of Manchester , Manchester , UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Berry
authors.affiliation: a Department of Clinical Psychology , University of Manchester , Manchester , UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Wearden
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000523:psychology; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011788:Quality of Life; D012944:Social Support
keywords: Expressed Emotion; burden; dementia; psychological well-being