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Recent Developments in Expressed Emotion and Schizophrenia

Published online by Cambridge University Press:  02 January 2018

David J. Kavanagh
David J. Kavanagh*
Affiliation:
Department of Psychology, Building A16, University of Sydney, NSW 2006, Australia
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Abstract

Expressed emotion (EE) has substantial scientific support as a predictor of relapse of positive symptoms. The median relapse rate in a high-EE environment is 48%, compared with 21% in a low-EE environment. This effect does not seem to be due to confounding with other variables, but it is subject to limitations in its scope of application. EE probably determines relapse through its effect on emotions and symptom control. A stress-vulnerability model of relapse is advanced that incorporates biological factors as well as cycles of mutual influence between symptomatic behaviour, life events, and EE. Aversive types of behaviour in patients and their relatives are seen as understandable reactions to stress that are moderated by social perceptions and coping skills. Families have made positive achievements, including the provision of non-invasive support.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 160 , Issue 5 , May 1992 , pp. 601 - 620
Copyright
Copyright © The Royal College of Psychiatrists, 1992 

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References

Anderson, C. M., Hogarty, G., Bayer, T., et al (1984) Expressed emotion and social networks of parents of schizophrenic patients. British Journal of Psychiatry, 144, 247–255.CrossRefGoogle ScholarPubMed
Anderson, C. M., Reiss, D. J. & Hogarty, G. E. (1986) Schizophrenia in the Family: A Practitioner's Guide to Psychoeducation and Management. New York: Guilford.Google Scholar
Arévalo, J. & Vizcarro, C. (1989) “Emotion expresada” y curso de la esquizofrenia en una muestra espanola. Analisis y Modificacion de Conducta, 15, 3–23.Google Scholar
Bandura, A. (1977) Self-efficacy: toward a unifying theory of behavioural change. Psychological Review, 84, 191–215.CrossRefGoogle Scholar
Bandura, A. (1982) Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147.CrossRefGoogle Scholar
Barrelet, L., Ferrero, F., Szigethy, L., et al (1990) Expressed emotion and first-admission schizophrenia: nine-month follow-up in a French cultural environment. British Journal of Psychiatry, 156, 357–362.CrossRefGoogle Scholar
Barrowclough, C. & Tarrier, N. (1984) ‘Psychosocial’ interventions with families and their effects on the course of schizophrenia: a review. Psychological Medicine, 14, 629–642.CrossRefGoogle ScholarPubMed
Barrowclough, C. & Tarrier, N. (1990) Social functioning in schizophrenic patients: I. The effects of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology, 25, 125–129.CrossRefGoogle ScholarPubMed
Birchwood, M. & Smith, J. (1987) Schizophrenia and the family. In Coping with Disorder in the Family (ed. Orford, J.). Beckenham: Croom Helm.Google Scholar
Birchwood, M. & Cochrane, R. (1990) Families coping with schizophrenia: coping styles, their origins and correlates. Psychological Medicine, 20, 857–865.CrossRefGoogle ScholarPubMed
Birchwood, M., Smith, J. & MacMillan, F. (1989) The development and implementation of an early warning system to predict relapse in schizophrenia. Psychological Medicine, 19, 649–656.CrossRefGoogle Scholar
Birley, J. L. T. & Brown, G. W. (1970) Crises and life changes preceding acute schizophrenia. British Journal of Psychiatry, 116, 327–333.CrossRefGoogle ScholarPubMed
Breier, A. & Strauss, J. S. (1983) Self-control in psychotic disorders. Archives of General Psychiatry, 40, 1141–1145.CrossRefGoogle ScholarPubMed
Brewin, 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, 546–554.CrossRefGoogle ScholarPubMed
Brown, G. W., Monck, E. M., Carstairs, G. M., et al (1962) Influence of family life on the course of schizophrenic illness. British Journal of Preventative Social Medicine, 16, 55–68.Google Scholar
Brown, G. W. & Rutter, M. (1966) The measurement of family activities and relationships: a methodological study. Human Relations, 19, 241–263.CrossRefGoogle Scholar
Brown, G. W. & Birley, J. L. T. (1968) Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203–214.CrossRefGoogle ScholarPubMed
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.CrossRefGoogle ScholarPubMed
Buchkremer, G., Stricker, K., Holle, R., et al (1991) The predictability of relapses in schizophrenic patients. European Archives of Psychiatry and Clinical Neurosciences, 240, 292–300.CrossRefGoogle ScholarPubMed
Budzyna-Dawidowski, P., Rostworowska, M. & de Barbaro, B. (1989) Stability of expressed emotion: a 3 year follow-up study of schizophrenic patients. Paper presented to the XIX Congress of the European Association of Behaviour Therapy, Vienna, September 1989.Google Scholar
Cazullo, C. L., Bertrando, P., Bressi, C., et al (1988) Emotività expressa e schizofrenia: studio prospettico di replicazione. Notizie ARS (suppl. 3/88), 16–21.Google Scholar
Cole, J. D. & Kazarian, S. S. (1988) The level of expressed emotion scale: a new measure of expressed emotion. Journal of Clinical Psychology, 44, 392–397.3.0.CO;2-3>CrossRefGoogle Scholar
Cozolino, L. J., Goldstein, M. J., Nuechterlein, K. S., et al (1988) The impact of education about schizophrenia on relatives varying in levels of expressed emotion. Schizophrenia Bulletin, 14, 675–686.CrossRefGoogle Scholar
Cramer, P., Weegmann, M. & O'Neil, M. (1989) Schizophrenia and the perception of emotions – How accurately do schizophrenics judge the emotional states of others? British Journal of Psychiatry, 155, 225–228.CrossRefGoogle ScholarPubMed
Creer, C. & Wing, J. K. (1974) Schizophrenia at Home. Surbiton: National Schizophrenia Fellowship.Google Scholar
Crotty, P. & Kulys, R. (1986) Are schizophrenics a burden to their families? Significant others' views. Health and Social Work, Summer, 173–188.CrossRefGoogle Scholar
Davis, J. (1975) Overview: maintenance therapy in psychiatry: I. Schizophrenia. American Journal of Psychiatry, 132, 1237–1245.Google ScholarPubMed
Doane, J. A., Goldstein, M. J., Mikowitz, D. J., et al (1986) The impact of individual and family treatment on the affective climate of families of schizophrenics. British Journal of Psychiatry, 148, 279–287.CrossRefGoogle ScholarPubMed
Doane, J. A., West, K. L., Goldstein, M. J., et al (1981) Parental communication deviance and affective style: predictors of subsequent schizophrenia spectrum disorders in vulnerable adolescents. Archives of General Psychiatry, 38, 679–685.CrossRefGoogle ScholarPubMed
Drake, R. E. & Sederer, L. I. (1986) The adverse effects of intensive treatment of chronic schizophrenia. Comprehensive Psychiatry, 27, 313–326.CrossRefGoogle ScholarPubMed
Dulz, B. & Hand, I. (1986) Short-term relapse in young schizophrenics: can it be predicted and affected by family (CFI), patient and treatment variables? An experimental study. In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M. J., Hand, I. & Hahlweg, K.), pp. 59–75. Berlin: Springer-Verlag.CrossRefGoogle Scholar
El-Islam, M. F. (1982) Rehabilitation of schizophrenics by the extended family. Acta Psychiatrica Scandinavica, 65, 112–119.CrossRefGoogle ScholarPubMed
El-Islam, M. F. (1989) Collaboration with families for the rehabilitation of schizophrenic patients and the concept of expressed emotion. Acta Psychiatrica Scandinavica, 65, 112–119.Google Scholar
Fadden, G., Bebbington, P. & Kuipers, L. (1987) The burden of care: the impact of functional illness on the patient's family. British Journal of Psychiatry, 150, 285–292.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. & Talbot, R. E. (1981) Persistent auditory hallucinations: coping mechanisms and implications for management. Psychological Medicine, 11, 329–339.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L., McGill, C. W., et al (1982) Family management in the prevention of exacerbations of schizophrenia: a controlled study. New England Journal of Medicine, 306, 1437–1440.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L. & McGill, C. W., (1984) Family Care of Schizophrenia. New York: Guilford Press.Google Scholar
Falloon, I. R. H., Boyd, J. L., McGill, C. W., et al (1985) Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal study. Archives of General Psychiatry, 42, 887–896.CrossRefGoogle ScholarPubMed
Fischman-Havstad, L. & Marston, A. R. (1984) Weight loss maintenance as an aspect of family emotion and process. British Journal of Clinical Psychology, 23, 265–271.CrossRefGoogle Scholar
Flanagan, D. A. J. & Wagner, H. L. (1991) Expressed emotion and panic-fear in the prediction of diet treatment compliance. British Journal of Clinical Psychology, 30, 231–240.CrossRefGoogle ScholarPubMed
Fleiss, J. L. (1973) Statistical Methods for Rates and Proportions. New York: Wiley.Google Scholar
Fulker, D. W. (1973) A biometrical genetic approach to intelligence and schizophrenia. Social Biology, 20, 266–275.CrossRefGoogle ScholarPubMed
Glynn, S. M., Randolph, E. T., Eth, S., et al (1990) Patient psychopathology and expressed emotion in schizophrenia. British Journal of Psychiatry, 157, 877–880.CrossRefGoogle ScholarPubMed
Goldstein, M. J. (1987) The UCLA high risk project. Schizophrenia Bulletin, 13, 505–514.CrossRefGoogle ScholarPubMed
Goldstein, M. J. & Kopeikin, H. (1981) Short and long-term effects of combining drug and family therapy. In New Developments in Interventions with Families of Schizophrenics (ed. Goldstein, M.), pp. 5–26. San Francisco: Jossey-Bass.Google Scholar
Goldstein, M. J. & Kreisman, D. (1988) Gender, family environment and schizophrenia. Psychological Medicine, 18, 861–872.CrossRefGoogle ScholarPubMed
Goldstein, M. J., Miklowiktz, D. J., Strachan, A. M., et al (1989) Patterns of expressed emotion and patients' coping styles that characterise the families of recent onset schizophrenics. British Journal of Psychiatry, 155 (suppl. 5), 107–111.CrossRefGoogle Scholar
Gottschalk, L. A., Falloon, I. R. H., Marder, S. R., et al (1988) The prediction of relapse of schizophrenic patients using emotional data obtained from their relatives. Psychiatry Research, 25, 261–276.CrossRefGoogle ScholarPubMed
Greenley, J. R. (1986) Social control and expressed emotion. Journal of Nervous and Mental Disease, 174, 24–30.CrossRefGoogle ScholarPubMed
Gutierrez, E., Escudero, V., Valero, J. A., et al (1988) Expresión de emociones y curso de la esquizofrenia: II. Expresión de emociones y curso de la esquizofrenia en pacientes en remisión. Análisisy modificación de Conducta, 14, 275–316.Google Scholar
Hahlweg, K., Goldstein, M. J., Nuechterlein, K. H., et al (1989) Expressed emotion and patient-relative interaction in families of recent onset schizophrenics. Journal of Consulting and Clinical Psychology, 57, 11–18.CrossRefGoogle ScholarPubMed
Hatfield, A. E. (1979) The family as a partner in the treatment of mental illness. Hospital and Community Psychiatry, 30, 338–340.Google ScholarPubMed
Hatfield, A. B., Spaniol, L. & Zipple, A. M. (1987) Expressed emotion: a family perspective. Schizophrenia Bulletin, 13, 221–235.CrossRefGoogle ScholarPubMed
Herz, M. I. & Melville, C. (1980) Relapse in schizophrenia. American Journal of Psychiatry, 137, 801–805.Google ScholarPubMed
Herzog, T. (1992) Nurses, patients and relatives: a study of family patterns on psychiatric wards. In Family Intervention in Schizophrenia: Experiences and Orientations in Europe (eds Cazzullo, C. L. & Invemizzi, G.). Milan: ARS (in press).Google Scholar
Higson, M. & Kavanagh, D. J. (1988) A hostel-based psychoeducational intervention for schizophrenia: programme development and preliminary findings. Behaviour Change, 5, 85–89.CrossRefGoogle Scholar
Hogarty, G. E. (1985) Expressed emotion and schizophrenic relapse: implications from the Pittsburgh study. In Controversies in Schizophrenia (ed. Alpert, M.), pp. 354–365. New York: Guilford Press.Google Scholar
Hogarty, G. E., Anderson, C. M. & Reiss, D. J. (1987) Family psychoeducation, social skills training, and medication in schizophrenia: the long and the short of it. Psychophamacology Bulletin, 23, 12–11.Google Scholar
Hogarty, G. E., Anderson, C. M. & Reiss, D. J. et al (1986) Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. 1. One-year effects of a controlled study on relapse and expressed emotion. Archives of General Psychiatry, 43, 633–642.CrossRefGoogle Scholar
Hogarty, G. E., McEvoy, J. P., Munetz, M., et al (1988) Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia. Archives of General Psychiatry, 45, 797–805.CrossRefGoogle ScholarPubMed
Hooley, J. M., Orley, J. & Teasdale, J. D. (1986) Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 642–647.CrossRefGoogle ScholarPubMed
Hooley, J. M. & Teasdale, J. D. (1989) Predictors of relapse in unipolar depressives: expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology, 98, 229–235.CrossRefGoogle ScholarPubMed
Hubschmid, T. & Zemp, M. (1989) Interactions in high- and low-expressed emotion families. Social Psychiatry and Psychiatric Epidemiology, 24, 113–119.CrossRefGoogle Scholar
Ivanović, M. & Vuletić, Z. (1989) Expressed emotion in families of patients with frequent types of schizophrenia and influence on the course of illness: nine months follow-up. Paper presented to the XIX Congress of the European Association of Behaviour Therapy, Vienna, September 1989.Google Scholar
Kanter, J., Lamb, H. R. & Loeper, C. (1987) Expressed emotion in families: a critical review. Hospital and Community Psychiatry, 38, 374–380.Google ScholarPubMed
Karno, M., Jenkins, J. H., de la Selva, A., et al (1987) Expressed emotion and schizophrenic outcome among Mexican-American families. Journal of Nervous and Mental Disease, 175, 143–151.CrossRefGoogle ScholarPubMed
Katschnig, H. (ed.) (1986) Life Events and Psychiatric Disorders: Controversial Issues. Cambridge: Cambridge University Press.Google Scholar
Kavanagh, D. J. (1992) Interventions for families and social networks. In Schizophrenia: An Overview and Practical Handbook (ed. Kavanagh, D. J.). London: Chapman & Hall (in press).CrossRefGoogle Scholar
Köttgen, C., Sonnichsen, I., Mollenhauer, K., et al (1984) Group therapy with families of schizophrenic patients: results of the Hamburg Camberwell Family Interview Study III. International Journal of Family Psychiatry, 5, 83–94.Google Scholar
Kreisman, D. E., Simmens, S. J. & Joy, V. D. (1979) Rejecting the patient: preliminary validation of a self-report scale. Schizophrenia Bulletin, 5, 220–222.CrossRefGoogle ScholarPubMed
Kuipers, L., Sturgeon, D., Berkowitz, R., et al (1983) Characteristics of expressed emotion: its relationship to speech and looking in schizophrenic patients and their relatives. British Journal of Clinical Psychology, 22, 257–264.CrossRefGoogle ScholarPubMed
Kuipers, L. & Bebbington, P. (1988) Expressed emotion research in schizophrenia: theoretical and clinical implications. Psychological Medicine, 18, 893–909.CrossRefGoogle ScholarPubMed
Leff, J. & Vaughn, C. (1980) The interaction of life events and relatives' expressed emotion in schizophrenia and depressive neurosis. British Journal of Psychiatry, 136, 146–153.CrossRefGoogle ScholarPubMed
Leff, J. & Vaughn, C. (1981) The role of maintenance therapy and relatives' expressed emotion in relapse of schizophrenia: a 2-year follow-up. British Journal of Psychiatry, 139, 102–104.CrossRefGoogle Scholar
Leff, J., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121–134.CrossRefGoogle ScholarPubMed
Leff, J., Kuipers, L., Berkowitz, R., et al (1985) A controlled trial of social intervention in the families of schizophrenic patients: two year follow-up. British Journal of Psychiatry, 146, 594–600.CrossRefGoogle ScholarPubMed
Leff, J. & Vaughn, C. (1985) Expressed Emotion in Families: Its Significance for Mental Illness. New York: Guilford Press.Google Scholar
Leff, J. & Vaughn, C. (1987) Expressed emotion (correspondence). Hospital and Community Psychiatry, 38, 1117–1118.Google Scholar
Leff, J., Wig, N. N., Ghosh, A., et al (1987) Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh. British Journal of Psychiatry, 151, 166–173.CrossRefGoogle ScholarPubMed
Leff, J., Berkowitz, R., Shavit, N., et al (1989) A trial of family therapy v. a relatives group for schizophrenia. British Journal of Psychiatry, 154, 58–66.CrossRefGoogle Scholar
Leff, J., Wig, N. N., Bedi, H., et al (1990) Relatives' expressed emotion and the course of schizophrenia in Chandigarh: a two-year follow-up of a first-contact sample. British Journal of Psychiatry, 156, 351–356.CrossRefGoogle ScholarPubMed
Leff, J., Berkowitz, R., Shavit, N., et al (1990) A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up. British Journal of Psychiatry, 157, 571–577.CrossRefGoogle Scholar
Lewinsohn, P. M. & Graf, M. (1973) Pleasant activities and depression. Journal of Consulting and Clinical Psychology, 41, 261–268.CrossRefGoogle ScholarPubMed
Linn, M. W., Klett, J. & Caffey, E. M. (1980) Foster home characteristics and psychiatric patient outcome: the wisdom of Gheel confirmed. Archives of General Psychiatry, 37, 129–132.CrossRefGoogle ScholarPubMed
MacCarthy, B., Hemsley, D., Shrank-Fernandez, C., et al (1986) Unpredictability as a correlate of expressed emotion in the relatives of schizophrenics. British Journal of Psychiatry, 148, 727–731.CrossRefGoogle ScholarPubMed
MacMillan, J. F., Gold, A., Crow, T. J., et al (1986) The Northwick Park study of first episodes of schizophrenia. IV. Expressed emotion and relapse. British Journal of Psychiatry, 148, 133–143.CrossRefGoogle Scholar
MacMillan, J. F., Crow, T. J., Johnson, A. L., et al (1987) Expressed emotion and relapse in first episodes of schizophrenia. British Journal of Psychiatry, 151, 320–323.CrossRefGoogle ScholarPubMed
MagAna, A. B., Goldstein, M. J., Karno, M., et al (1986) A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 17, 203–212.CrossRefGoogle ScholarPubMed
McCreadie, R. G. & Robinson, A. D. T. (1987) The Nithsdale schizophrenia survey. VI. Relatives' expressed emotion: prevalence, patterns, and clinical assessment. British Journal of Psychiatry, 150, 640–644.CrossRefGoogle ScholarPubMed
McCreadie, R. G. & Phillips, K. (1988) The Nithsdale schizophrenia survey. VII. Does relatives' high expressed emotion predict relapse? British Journal of Psychiatry, 152, 477–481.CrossRefGoogle ScholarPubMed
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, 359–367.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J. & Falloon, I. R. H. et al (1984) Interactional correlates of expressed emotion in the families of schizophrenics. British Journal of Psychiatry, 144, 482–487.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., et al (1986) Expressed emotion, affective style, lithium compliance, and relapse in recent-onset mania. Psychopharmacology Bulletin, 22, 628–632.Google ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., et al (1988) Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225–231.CrossRefGoogle ScholarPubMed
Miklowitz, D. J., Goldstein, M. J., Doane, J. A., et al (1989) Is expressed emotion an index of a transactional process? I Parents' affective style. Family Process, 28, 153–167.CrossRefGoogle ScholarPubMed
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, 314–320.CrossRefGoogle ScholarPubMed
Mintz, L. I., Liberman, P., Miklowitz, D. J., et al (1987) Expressed emotion: a call for partnership among relatives, patients, and professionals. Schizophrenia Bulletin, 13, 227–235.CrossRefGoogle Scholar
Mintz, L. I., Nuechterlein, 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, 212–217.CrossRefGoogle ScholarPubMed
Moline, R. E., Singh, S., Morris, A., et al (1985) Family expressed emotion and relapse in schizophrenia in 24 urban American patients. American Journal of Psychiatry, 142, 1078–1081.Google ScholarPubMed
Montero, I., Gomez Beneyto, M., Ruiz, I., et al (1990) Emotional expressiveness and development of schizophrenia: a reply to the work of Vaughn. Actas Luso-Espanolas de Neurologia, Psiquiatria y Ciencias Afines, 18, 387–395.Google Scholar
Možný, P., Petrikovitsová, A., Lavická, Z., et al (1989) Expressed emotions, relapse rate and utilization of psychiatric hospital care in schizophrenia. Paper presented to the XIX Congress of the European Association of Behaviour Therapy, Vienna, September 1989.Google Scholar
Nuechterlein, K. H. & Dawson, M. E. (1984) A heuristic vulnerability-stress model of schizophrenic episodes. Schizophrenia Bulletin, 10, 300–312.CrossRefGoogle ScholarPubMed
Nuechterlein, K. H., Snyder, K. S., Dawson, M. E., et al (1986) Expressed emotion, fixed-dose fluphenazine decanoate maintenance, and relapse in recent-onset schizophrenia. Psychopharmacology Bulletin, 22, 633–639.Google ScholarPubMed
O'Halloran, P., Kavanagh, D. J., Piatkowska, O., et al (1989) The Family Attitude Questionnaire. Unpublished scale, University of Sydney.Google Scholar
Parker, G. (1983) Parental Overprotection: A Risk Factor in Psychosocial Development. New York: Grune & Stratton.Google Scholar
Parker, G., Fairley, M., Greenwood, J., et al (1982) Parental representations of schizophrenics and their association with onset and course of schizophrenia. British Journal of Psychiatry, 141, 573–581.CrossRefGoogle ScholarPubMed
Parker, G. & Johnston, P. (1987) Parenting and schizophrenia: An Australian study of expressed emotion. Australian and New Zealand Journal of Psychiatry, 21, 60–66.CrossRefGoogle ScholarPubMed
Parker, G., Johnston, P. & Hayward, L. (1988) Parental ‘expressed emotion’ as a predictor of schizophrenic relapse. Archives of General Psychiatry, 45, 806–813.CrossRefGoogle ScholarPubMed
Parker, G., Hayward, L. & Johnston, P. (1989) Factorial validity of the EE scales. Psychological Medicine, 19, 435–446.CrossRefGoogle ScholarPubMed
Patterson, G. R. (1982) Coercive Family Process. Eugene, OR: Castilia.Google Scholar
Piatkowska, O., Kavanagh, D., Manicavasagar, V., et al (1992) Cognitive–Behavioral Family Intervention for Schizophrenia. Pergamon (submitted for publication).Google Scholar
Potasznik, H. & Nelson, G. (1984) Stress and social support: the burden experienced by the family of a mentally ill person. American Journal of Community Psychology, 12, 589.CrossRefGoogle ScholarPubMed
Priebe, S., Wildgrube, C. & Muller-Oerlinghausen, B. (1989) Lithium prophylaxis and expressed emotion. British Journal of Psychiatry, 154, 396–399.CrossRefGoogle ScholarPubMed
Rostworowska, M., Barbaro, B. & Cechnicki, A. (1987) The influence of expressed emotion on the course of schizophrenia: a Polish replication. Poster presented at the 17th Congress of the European Association for Behaviour Therapy, Amsterdam, 26–29 August.Google Scholar
Rutter, M. & Brown, G. W. (1966) The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry, 1, 38–53.CrossRefGoogle Scholar
Sartorius, N., Jablensky, A., Korten, A., et al (1986) Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine, 16, 909–928.CrossRefGoogle ScholarPubMed
Schnur, D. B., Friedman, S., Dorman, M., et al (1986) Assessing the family environment of schizophrenic patients with multiple hospital admissions. Hospital and Community Psychiatry, 37, 249–252.Google ScholarPubMed
Seywert, F. (1984) Some critical thoughts on expressed emotion. Psychopathology, 17, 233–243.CrossRefGoogle ScholarPubMed
Smith, J. V. & Birchwood, M. J. (1987) Education for families with schizophrenic relatives. British Journal of Psychiatry, 150, 645–652.CrossRefGoogle Scholar
Smith, J. V. & Birchwood, M. J. (1990) Relatives and patients as partners in the management of schizophrenia: the development of a service model. British Journal of Psychiatry, 156, 654–660.CrossRefGoogle ScholarPubMed
Strachan, A. M. (1986) Family intervention for the rehabilitation of schizophrenia. Schizophrenia Bulletin, 12, 678–698.CrossRefGoogle ScholarPubMed
Strachan, A. M., Goldstein, M. J. & Miklowitz, D. J. (1986) Do relatives express expressed emotion? In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M. J., Hand, I. & Hahlweg, K.), pp. 52–58. Berlin: Springer-Verlag.Google Scholar
Strachan, A. M., Leff, J. P., Goldstein, M. J., et al (1986) Emotional attitudes and direct communication in the families of schizophrenics: A cross-national replication. British Journal of Psychiatry, 149, 279–287.CrossRefGoogle ScholarPubMed
Strachan, A. M., Feingold, D., Goldstein, M. J., et al (1989) Is expressed emotion an index of a transactional process? II. Patients' coping style. Family Process, 28, 169–181.CrossRefGoogle Scholar
Straube, E. R., Wagner, W., Foerster, K., et al (1989) Findings significant with respect to short- and long-term outcome in schizophrenia – a preliminary report. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 13, 185–197.CrossRefGoogle Scholar
Sturgeon, D., Turpin, G., Berkowitz, R., et al (1984) Psychophysiological responses of schizophrenic patients to high and low expressed emotion relatives: a follow-up study. British Journal of Psychiatry, 145, 62–69.CrossRefGoogle ScholarPubMed
Subotnik, K. L. & Nuechterlein, K. H. (1988) Prodromal signs and symptoms of schizophrenic relapse. Journal of Abnormal Psychology, 97, 405–412.CrossRefGoogle ScholarPubMed
Szmukler, G. I., Berkowitz, R., Eisler, I., et al (1987) Expressed emotion in individual and family settings: a comparative study. British Journal of Psychiatry, 151, 174–178.CrossRefGoogle ScholarPubMed
Tarrier, N. (1989) Electrodermal activity, expressed emotion and outcome in schizophrenia. British Journal of Psychiatry, 155 (suppl. 5), 51–56.CrossRefGoogle Scholar
Tarrier, N., Vaughn, C., Lader, M. H., et al (1979) Bodily reactions to people and events in schizophrenia. Archives of General Psychiatry, 36, 311–315.CrossRefGoogle Scholar
Tarrier, N., Barrowclough, C., Porceddu, K., et al (1988) The assessment of physiological reactivity to the expressed emotion of the relative of schizophrenic patients. British Journal of Psychiatry, 152, 618–624.CrossRefGoogle Scholar
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1988) The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1989) Community management of schizophrenia: a two-year follow-up of a behavioural intervention with families. British Journal of Psychiatry, 154, 625–628.CrossRefGoogle ScholarPubMed
Tarrier, N. & Barrowclough, C. (1990) Social functioning in schizophrenia: II. The effects of autonomic arousal. Social Psychiatry and Psychiatric Epidemiology, 25, 130–131.CrossRefGoogle ScholarPubMed
Torrey, E. F. (1989) Editorial. Schizophrenia: fixed incidence or fixed thinking? Psychological Medicine, 19, 85–287.CrossRefGoogle ScholarPubMed
Turpin, G., Tarrier, N. & Sturgeon, D. (1988) Social psychophysiology and the study of biopsychosocial models of schizophrenia. In Social Psychophysiology: Theory and Clinical Applications (ed. Wagner, H.). Chichester: Wiley.Google Scholar
Valone, K., Norton, J. P., Goldstein, M. J., et al (1983) Parental expressed emotion and affective style in an adolescent sample at risk for schizophrenia spectrum disorders. Journal of Abnormal Psychology, 92, 399–407.CrossRefGoogle Scholar
Vaughan, K., McConaghy, N., Doyle, M., et al (1992) The relationship between relatives' expressed emotion and schizophrenic relapse: an Australian replication. (Submitted).CrossRefGoogle Scholar
Vaughn, C. E. (1986) Patterns of emotional response in the families of schizophrenic patients. In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M. J., Hand, I. & Hahlweg, K.), pp. 97–106. Berlin: Springer-Verlag.CrossRefGoogle Scholar
Vaughn, C. E. (1989) Annotation. Expressed emotion in family relationships. Journal of Child Psychology and Psychiatry, 30, 13–22.CrossRefGoogle Scholar
Vaughn, C. E. & Leff, J. (1976) The influence of family and social factors on the course of psychiatric illness. British Journal of Psychiatry, 129, 125–137.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. (1976) The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.CrossRefGoogle ScholarPubMed
Vaughn, C. E., Snyder, K. S., Jones, S., et al (1984) Family factors in schizophrenic relapse: replication in California of British research on expressed emotion. Archives of General Psychiatry, 41, 1169–1177.CrossRefGoogle ScholarPubMed
Waxler, N. (1979) Is outcome for schizophrenia better in nonindustrial societies? The case of Sri Lanka. Journal of Nervous and Mental Diseases, 167, 144–158.CrossRefGoogle ScholarPubMed
Wig, N. N., Menon, D. K., Bedi, H., et al (1987) Expressed emotion and schizophrenia in North India: I. Cross-cultural transfer of ratings of relatives' expressed emotion. British Journal of Psychiatry, 151, 156–173.CrossRefGoogle Scholar
Wing, J. K. (1978) The social context of schizophrenia. American Journal of Psychiatry, 135, 1333–1339.Google ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and CATEGO system. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1979) Schizophrenia: An International Follow-up Study. New York: Wiley.Google Scholar
Zubin, J. & Spring, B. (1977) Vulnerability: a new view of schizophrenia. Journal of Abnormal Psychology, 86, 103–126.CrossRefGoogle ScholarPubMed
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