title: Relatives' expressed emotion, distress and attributions in clinical high-risk and recent onset of psychosis.
abstract: It has been well-demonstrated that Expressed Emotion (EE) in caregivers of schizophrenia patients is related to their illness attributions, but little is known about relatives' cognitive and emotional appraisals at early stages of psychosis. This study examined differences on the relationships of EE with distress and illness attributions in 78 relatives of At-Risk Mental States (ARMS) and First-Episode of Psychosis (FEP) patients, and which of those variables better predicted EE. Criticism and Emotional Over-Involvement (EOI) were associated with distress and with several illness attributions in both groups. Anxiety was more strongly associated with criticism in ARMS than in FEP-relatives, and it was associated with EOI in the ARMS but not in the FEP-group. No differences on the relationships of EE with depression or attributions were found. Furthermore, distress and attributions of blame toward the patients predicted criticism. Attributions of control by the patient and emotional negative representation about the disorder predicted EOI. Findings highlight the need to focus on early family interventions that provide proper information and psychological support in accordance with the illness stage, to help relatives improve their understanding of the disorder, handle difficult thoughts and emotions, reduce negative appraisals, and prevent high-EE over the psychotic process.
authors.affiliation: CONACYT- Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Dirección de Investigaciones Epidemiológicas y Psicosociales, Mexico City, Mexico.
authors.forename: Tecelli
authors.initials: T
authors.lastname: Domínguez-Martínez
authors.affiliation: Departamento de Educación, Universidad Internacional de La Rioja, Spain; Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Sevilla, Sevilla, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Medina-Pradas
authors.affiliation: Department of Psychology, University of Illinois at Urbana-Champaign, USA.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kwapil
authors.affiliation: Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain; Departament de Salut Mental. Sant Pere Claver- Fundació Sanitària, Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: neus.barrantes@uab.cat.
authors.forename: Neus
authors.initials: N
authors.lastname: Barrantes-Vidal
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology*; D012306:Risk; D013315:Stress, Psychological / Q000523:psychology*
keywords: Appraisals; Criticism; Distress; Early psychosis; Emotional over-involvement; Family