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The Initial Onset of Schizophrenia and Family Expressed Emotion

Some Methodological Considerations

Published online by Cambridge University Press:  02 January 2018

Lois Imber Mintz
Affiliation:
Department of Psychology, University of California, Los Angeles
Keith H. Nuechterlein*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences
Michael J. Goldstein
Affiliation:
Department of Psychiatry and Biobehavioral Sciences
Jim Mintz
Affiliation:
Department of Psychiatry and Biobehavioral Sciences
Karen S. Snyder
Affiliation:
Department of Psychiatry and Biobehavioral Sciences
*
UCLA Neuropsychiatric Institute, 760 Westwood Plaza, Los Angeles, CA 90024, USA

Abstract

The relationships between duration of schizophrenic illness before first hospital admission, expressed emotion in key relatives, and illness course have yielded conflicting reports. This study examined the issue from a methodological perspective in a sample of first-episode schizophrenic patients. A ‘best estimate’ of illness onset, based on a compilation of all sources, was compared with an estimate based on parental report. Parental estimates suggested that the children of high-EE parents had been ill for significantly longer, but this difference was not confirmed by the best estimate. In most cases, the ill children of high-EE parents were living at home before hospital admission and their parents' estimates of duration were quite accurate. In the few cases in which the child was living away from home, high-EE parents strikingly overestimated duration. Children of low-EE families were more likely to be living away from home, but this factor did not explain the consistent underestimates of duration made by their parents. Although duration of illness did not relate to EE, successful engagement in out-patient before in-patient treatment was more common among children from low-EE families.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Brockington, I. F. & Meltzer, H. Y. (1982) Documenting an episode of psychiatric illness: need for multiple information sources, multiple raters, and narrative. Schizophrenia Bulletin, 8, 485492.CrossRefGoogle ScholarPubMed
Brown, G. W., Monck, G. M., Carstairs, G. M., et al (1962) Influence of family life on the course of schizophrenic illness. British Journal of Preventive Social Medicine, 16, 5568.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family and social factors on the course of psychiatric disorders: a replication. British Journal of Psychiatry, 121, 241258.Google Scholar
Goldstein, M. J. (1978) Further data concerning the relation between premorbid adjustment and paranoid symptomatology. Schizophrenia Bulletin, 4, 236243.Google Scholar
MacMillan, J. F., Gold, A., Crow, T. J., et al (1986) The North wick Park Study of First Episodes of Schizophrenia: IV. Expressed emotion and relapse. British Journal of Psychiatry, 148, 133143.CrossRefGoogle Scholar
Miklowitz, D. J., Goldstein, M. J., & Falloon, I. R. H. (1983) Premorbid and symptomatic characteristics of schizophrenics from families with high and low levels of expressed emotion. Journal of Abnormal Psychology, 92, 359367.Google Scholar
Mintz, J., Mintz, L. & Goldstein, M. (1987) Expressed emotion and relapse in first-episodes of schizophrenia: a rejoinder to MacMillan et al (1986). British Journal of Psychiatry, 151, 314320.Google Scholar
Nuechterlein, K. H., Edell, W. S., Norris, M., et al (1986a) Attentional vulnerability indicators, thought disorder, and negative symptoms. Schizophrenia Bulletin, 12, 408426.Google Scholar
Nuechterlein, , Snyder, K. S., Dawson, M. E., et al (1986b) Expressed emotion, fixed-dose fluphenazine decanoate maintenance, and relapse in recent-onset schizophrenia. Psychopharmacology Bulletin, 22, 633639.Google ScholarPubMed
Parker, G. & Johnson, P. (1987) Parenting and schizophrenia: an Australian study of expressed emotion. Australian and New Zealand Journal of Psychiatry, 21, 6066.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976) The measurement of expressed emotion in families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157165.Google Scholar
Vaughn, C. E., Snyder, K. S., Jones, S., et al (1984) Family factors in schizophrenic relapse: a California replication of the British research on expressed emotion. Archives of General Psychiatry, 41, 11691177.CrossRefGoogle ScholarPubMed
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