Control and controllability: beliefs and behaviour in high and low expressed emotion relatives
Control and controllability: beliefs and behaviour in high and low expressed emotion relatives
复制标题
DOI：
10.1017/s0033291702005779
复制
发表时间：
2002-08-01
影响因子：
6.9
通讯作者：
Campbell, C
中科院分区：
文献类型：
--
作者：
Hooley, JM;Campbell, C
背景。表达情感（EE）是一种衡量家庭环境的方法，是一种很好的心理社会预测精神疾病复发的方法。情感表达的理论模型非常强调控制的概念。我们探讨了高情感表达和低情感表达亲属对患者的控制归因和参与控制行为的程度。训练有素的评分者对情感表达信息一无所知，他们与35名精神分裂症患者的亲属和42名单相抑郁症患者的亲属进行了编码访谈。研究人员用两种可靠的量表对亲属进行评分，分别评估亲属将疾病可控归因的倾向和亲属对患者施加直接行为控制的努力。在精神分裂症和抑郁症两组中，高情感表达的亲属比低情感表达的亲属更能控制他们患病的家庭成员。他们也表现得更有控制欲。在9个月的随访期间，对患者临床结果的检查显示，高水平的亲属行为控制显著预测精神分裂症患者的复发，但对抑郁症患者没有影响。这些发现支持基于归因的情感表达模型。他们进一步提出，亲属的控制行为可能介导精神分裂症的ee -复发联系。这些行为可能是精神分裂症家庭干预中需要修改的重要目标。
Background. Expressed emotion (EE) is a measure of the family environment that is a well replicated psychosocial predictor of psychiatric relapse. Theoretical models of EE place heavy emphasis on the notion of control. We explored the extent to which high and low EE relatives made both attributions of control about patients and engaged in controlling behaviours.Methods. Trained raters who were blind to information about EE coded interviews with 35 relatives of patients with schizophrenia and 42 relatives of patients with unipolar depression. Relatives were rated on two reliable scales that assessed relatives' tendencies to make illness controllability attributions and relatives' efforts to exert direct behavioural control over patients.Results. In both the schizophrenia and depressed groups, high-EE relatives attributed more control to their ill family members than did low EE relatives. They also behaved in a more controlling manner. Examination of patients' clinical outcomes during a 9-month follow-up period revealed that high levels of behavioural control on the part of relatives significantly predicted relapse in patients with schizophrenia but not in patients with depression.Conclusions. These findings support the attribution-based model of EE. They further suggest that controlling behaviours on the part of relatives may mediate the EE-relapse link in schizophrenia. Such behaviours may be important targets for modification in family-based interventions for schizophrenia.