Journal Article

Interpersonal Control and Expressed Emotion in Families of Persons With Schizophrenia: Change Over Time

Anne K. Wuerker, Gretchen L. Haas and Alan S. Bellack

in Schizophrenia Bulletin

Published on behalf of Maryland Psychiatric Research Center

Volume 27, issue 4, pages 671-686
Published in print January 2001 | ISSN: 0586-7614
Published online January 2001 | e-ISSN: 1745-1701 | DOI: http://dx.doi.org/10.1093/oxfordjournals.schbul.a006906
Interpersonal Control and Expressed Emotion in Families of Persons With Schizophrenia: Change Over Time

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This study examined communication patterns in 62 families of persons with schizophrenia, comparing families with relatives who were low expressed emotion (EE) at the beginning and end of a 2-year study, those who were high EE at the beginning and end, and those whose EE status changed. Interaction was coded with the Relational Control Coding System and analyzed as a Markov process. Dialogues in the stable low-EE and stable high-EE families were rather similar initially, and both groups showed increasing flexibility at year 1. However, at year 2, low-EE dyads showed increasingly complex structure and flexibility in control, but high-EE dyads showed simpler structure and rigidly controlling patterns. When EE status changed, so did the structure of the dialogues and the patterning of control. Although earlier research found more “tightly joined” systems in families of high-EE relatives, it may be that over time, these family members distance from each other and so are less connected. It is also possible that relatives who remain high EE despite intervention are a subset of high-EE relatives who need more support or different therapeutic approaches to maintain change.

Keywords: Schizophrenia; expressed emotion; Markov processes; longitudinal study; interpersonal control

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Subjects: Child and Adolescent Psychiatry

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