Expressed emotion in wives of myocardial infarction patients: an exploratory feasibility study

No correlation among expressed emotion, anxiety, stress and weight loss in patients with overweight and obesity

Background

The onset of some types of obesity may correlate with specific familial relational patterns, and expressed emotion (EE), the family life's 'emotional temperature', may play a role in obesity treatment compliance and outcome.

Objective

The aim of this study is to address the current gap in the literature about EE and obesity, assessing EE in a sample of patients with overweight or obesity and their relatives. A further objective is to assess patients' weight loss, patients' and relatives' anxiety, perceived stress and their possible correlation with EE and diet compliance.

Design

A total of 220 patients with overweight or obesity and 126 relatives were recruited; their socio-demographic and clinical features were collected; and Level of Expressed Emotion Scale (LEE), State-Trait Anxiety Inventory 1 and 2 (STAI-Y1 and STAI-Y2) and Paykel Scale of Stressful Life Events were administered.

Results

Patients' baseline body mass index (BMI) was negatively correlated with educational level, but we failed to find any correlation between BMI and the other variables assessed. We found a positive correlation between EE median and stressful life events, as well as between median EE and state and trait anxiety.

Conclusions

Our results seem to suggest that other factors than the psychological ones we investigated may play a role in treatment adherence and outcome in patients with overweight and obesity.

Perceived expressed emotions in relatives of patients with severe mental illness: A comparative study

There is paucity of studies on expressed emotion (EE) in families of patients with severe mental illness in sub-Saharan Africa. This study aimed to assess and compare the levels of expressed emotion (LEE) in relatives of patients with schizophrenia and bipolar affective disorder attending an out-patient clinic in Southwestern Nigeria. One hundred and forty consecutive clinic attendees with Mini-Plus diagnosis of schizophrenia and bipolar affective disorder and 140 accompanying relatives were recruited. The patients and relatives were interviewed using a socio-demographic questionnaire. The perceived level of expressed emotion was assessed using the client version of the Level of Expressed Emotion Questionnaire (LEEQ). Although, the prevalence of high expressed emotion was higher among relatives of patients with schizophrenia when compared with relatives of patients with bipolar affective disorder (41% vs 37%), the difference was not statistically significant. The socio-demographic characteristics of the relatives of patients with these disorders were not significantly related to high EE. High expressed emotion is just as prevalent among relatives of patients with bipolar affective disorder as among relatives of patients with schizophrenia and clinicians should give similar attention to early detection of high EE and intervention in this population of patients and their relatives.

The relationship between family expressed emotion, perceived criticism and criticism sensitivity and psychiatric outcomes following traumatic brain injury

Family expressed emotion (EE) is a strong predictor of outcome in a range of psychiatric and medical conditions. This study aimed to examine the relationship between family EE-criticism, patient perceived criticism and criticism sensitivity and psychiatric disorders following moderate to severe traumatic brain injury (TBI). Participants were 60 patients with TBI and their family members. Patients were assessed for psychiatric disorders using the Structured Clinical Interview for DSM-IV (SCID-I) and completed the Perceived Criticism Measure (PCM) to determine levels of perceived criticism and criticism sensitivity. Family members completed the Family Questionnaire (FQ) to assess patient directed EE-criticism. Patients were reassessed approximately 12-months post-baseline. After controlling for diagnostic status at baseline, high criticism sensitivity at baseline was associated with greater probability of psychiatric diagnosis at follow-up (odds ratio=3.99, 95% CI=1.15-13.71). Family EE-criticism and perceived criticism were not predictive of patient diagnostic status at follow-up, but patients with high EE-family members were more likely to have a concurrent psychiatric diagnosis at baseline. Findings suggest that sensitivity to interpersonal criticism may have a role in the development and course of psychiatric disorders following TBI.

Post-stroke depression and expressed emotion

PRIMARY OBJECTIVES

This study examined the role of expressed emotion (EE) in post-stroke depression (PSD) and the extent to which partner/spouse EE interacted with lesion laterality in PSD. The relationship between (i) lesion location and levels of PSD and (ii) levels of EE and levels of PSD were investigated. The role of perceived EE in PSD was also explored.

DESIGN

Cross-sectional, between-subjects design.

METHODS

Measures applied to stroke survivors included Extended Activities of Daily Living Scale (EADL), Post-Stroke Depression Rating Scale (PSDRS) and Level of Expressed Emotion Scale (LEE); spouses/partners completed the LEE.

RESULTS

The interaction between lesion laterality and levels of partner/spouse EE on PSD was not statistically significant (p = 0.63, F = 0.24, df = 1,56). However, a clear relationship was found between lesion laterality and PSD (p = 0.028). As levels of spouse/partner LEE scores increased, levels of PSD also increased (p = 0.039). Perceived EE scores illustrated a significant interaction between lesion laterality and levels of EE on PSD (p = 0.005, F = 8.591, df = 1,56).

CONCLUSION

Whilst spouse/partner EE scores showed no interaction with lesion laterality to determine levels of PSD, a significant interaction was found when compared with stroke survivor perceived EE scores. Furthermore, left hemisphere (LHS) stroke survivors reported higher levels of depression than right hemisphere (RHS) stroke survivors. As levels of EE increased, PSD also increased, with LHS being greater than RHS.