CULTURE AND FAMILY REACTIONS TO SCHIZOPHRENIA

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The proposed study expands on a program of research examining factors associated with family members' reactions to schizophrenia. Specifically, this study will test a conceptual model designed to clarify factors underlying observed differences between Anglo- American and Latino-American relatives' reactions to a family member with schizophrenia. Understanding reactions to schizophrenia is crucial because research in the area of expressed emotion (EE) strongly suggests that patients who live with relatives who are emotionally overinvolved, express an excessive number of critical comments, and/or express any degree of hostility (designated as high-EE relatives) when talking about the patient during a structured clinical interview have a poorer illness prognosis than patients whose relatives do not express as many of these unfavorable emotions. Studies associating high-EE with poor prognosis for schizophrenia have been replicated with a wide range of racial and ethnic groups (Asian-Indians, Anglo-Americans, Spanish, etc.), yet certain cultural differences in EE patterns have been found to exist. For example, when compared with "traditional" and/or "developing" societies, relatives from "industrialized" and/or less "traditional," cultures have been found to be designated as high-EE significantly more often and their patients show a poorer course of illness. In fact within the same geographic area of the United States, Anglo-Americans have been rated as high-EE three times more often than Latino-Americans of Mexican descent. Through a series of interviews with 25 Anglo- American and 25 Latino-American relatives, this study will examine whether cultural differences in EE patterns relate to relatives specific beliefs, values, and attributions about schizophrenia. It is hypothesized that, when compared to Anglo-Americans, relatives of Latino descent (Latinos are thought to represent a "traditional" cultural group) will report having a more interdependent self- construal, greater reported family cohesion, and greater moral- religious emphasis in their families in turn these values are expected to be associated with relatives attributing less blame to patients for bringing on the illness and the associated symptoms and consequently to lower levels of high EE in families. Findings from this study will further our theoretical understanding of EE and will inform the development of effective family focused intervention strategies for treating schizophrenia.