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Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia

Published online by Cambridge University Press:  03 January 2018

Christine Barrowclough*
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University of Manchester
Michael Parle
Affiliation:
Department of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University of Manchester
*
Christine Barrowlough, Department of Clinical Psychology, Withington Hospital. Manchester M20 8LR

Abstract

Background

It is argued that coping theory may be useful in attempting to understand how relatives adapt to the demands of living with a schizophrenia sufferer.

Method

In a prospective study, univariate and multivariate relationships were explored between appraisal variables (appraisal of symptom threat (primary appraisal) and perceived symptom control (secondary appraisal)) and (a) expressed emotion, and (b) psychological distress in relatives of schizophrenic patients. The profile of relatives who showed sustained distress over time was also examined.

Results

The appraisal variables were found to be related to both the concurrent distress (GHQ scores), EE ratings of relatives at the time of the patients relapse and hospitalisation, as well as the subsequent GHQ scores of relatives when the patient was discharged back home. Relatives who showed sustained distress were likely to show high EE and have a longer caring history.

Conclusions

The study gives some support to the theory that appraisal processes underlie how relatives react to having a family member with schizophrenia, and may have implications both for identifying those at risk of poor adaptation, and for understanding strategies that improve well-being.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Barrowclough, C. & Tarrier, N. (1992) Families of Schizophrenic Patients: Cognitive–Behavioural Intervention. London: Chapman & Hall.Google Scholar
Barrowclough, C. & Tarrier, N. & Johnston, M. (1994) Attributions, expressed emotion and patient relapse: an attributional model of relatives' response to schizophrenic illness, behaviour Therapy, 25, 6788.Google Scholar
Barrowclough, C. & Tarrier, N. & Johnston, M. (1996) Distress, expressed emotion and attributions in relatives of schizophrenic patients. Schizophrenia bulletin, 22, 691702.CrossRefGoogle Scholar
Bebbington, P. & Kuipers, L. (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychological Medicine, 24, 707718.CrossRefGoogle ScholarPubMed
Birchwood, M. & Cochrane, It. (1990) Families coping with schizophrenia: coping styles, their origins and correlates. Psychological Medicine, 20, 857865.Google Scholar
Browtn, C. R., Maccarthy, B., Duda, K., et al (1991) Attributions and expressed emotion in the relatives of patients with schizophrenia. Journal of Abnormal Psychology 100, 546554.Google Scholar
Goldberg, D. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER–Nelson.Google Scholar
Haley, W. E., Levine, E. G., Brown, S. L., et al (1987) Stress, appraisal, coping and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging. 2, 323330.Google Scholar
Holahan, C. J., Moos, R. H. & Schaefer, J. A. (1994) Coping, stress resistance, and growth: conceptualizing adaptive functioning. In Handbook of Coping: Theory. Research. Applications (eds M. Zeider & N. S. Endler), pp. 2443. New York: John Wiley.Google Scholar
Krawiecka, M., Goldberg, D. P. & Vaughn, M. (1977) A standardised psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatnca Scandmavica, 55, 299308.CrossRefGoogle ScholarPubMed
Lazarus, R. S. & Folkman, S. (1984) Stress. Appraisal and Coping. New York: Springer.Google Scholar
Maccarthy, B., Hemsley, D. R., Shrank-Fernandez, C., et al (1984) Unpredictability as a correlate of expressed emotion in the relatives of schizophrenics. British Journal of Psychiatry, 148, 727731.CrossRefGoogle Scholar
Mari, J. J. & Streiner, D. L. (1995) An overview of family interventions in relapse in schizophrenia: a meta analysis of research findings. Psychological Medicine, 24, 565578.Google Scholar
Mintz, L. I., Nuechteriein, K. H., Goldstein, M. J., et al (1989) The initial onset of schizophrenia and family expressed emotion: some methodological considerations. British Journal of Psychiatry. 154, 212217.CrossRefGoogle ScholarPubMed
Novaco, R. W. (1985) Anger and its therapeutic regulation. In Anger and Hostility in Cardiovascular and Behavioural Disorders (eds M. A. Chesney & R. H. Rosenman). pp. 203226. Washington. DC: Hemisphere.Google Scholar
Oldridge, M. L. & Hughes, I. C. T. (1992) Psychological well-being in families with a member suffering from schizophrenia. An investigation into longstanding problems. British Journal of Psychiatry, 141, 249251.Google Scholar
Parle, M., Jones, B. & Maguire, P. (1996) Maladaptive coping and affective disorders amongst cancer patients. Psychological Medicine. 26, 735744.Google Scholar
Scazufca, M. & Kuipers, E. (1996) Links between expressed emotion and burden of care in relatives of patients with schizophrenia. British Journal of Psychiatry, 148, 580587 CrossRefGoogle Scholar
Tarrier, N., Barrowclough, C., Vaughn, C. E., et al (1988) The community management of schizophrenia: a controlled trial of behavioural intervention to reduce relapse. British Journal of Psychiatry, 152, 618624.Google Scholar
Taylor, S. E. & Brown, J. D. (1994) Positive illusions and well being revisited: separating fact from fiction. Psychological Bulletin. 114, 2127.Google Scholar
Williams, J. M. G., Watts, F. N., Macleod, C., et al (1988) Cognitive Psychology and Emotional Disorders. Chichester: Wiley.Google Scholar
Winefield, H. R. & Harvey, E. J. (1993) Determinants of psychological distress in relatives of people with chronic schizophrenia. Schizophrenia Bulletin, 19, 619626.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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