RESUMO

It has been well-demonstrated that Expressed Emotion (EE) in caregivers of schizophrenia patients is related to their illness attributions, but little is known about relatives' cognitive and emotional appraisals at early stages of psychosis. This study examined differences on the relationships of EE with distress and illness attributions in 78 relatives of At-Risk Mental States (ARMS) and First-Episode of Psychosis (FEP) patients, and which of those variables better predicted EE. Criticism and Emotional Over-Involvement (EOI) were associated with distress and with several illness attributions in both groups. Anxiety was more strongly associated with criticism in ARMS than in FEP-relatives, and it was associated with EOI in the ARMS but not in the FEP-group. No differences on the relationships of EE with depression or attributions were found. Furthermore, distress and attributions of blame toward the patients predicted criticism. Attributions of control by the patient and emotional negative representation about the disorder predicted EOI. Findings highlight the need to focus on early family interventions that provide proper information and psychological support in accordance with the illness stage, to help relatives improve their understanding of the disorder, handle difficult thoughts and emotions, reduce negative appraisals, and prevent high-EE over the psychotic process.

Assuntos

RESUMO

The mechanisms underlying the association between expressed emotion (EE) and the prognosis in early psychosis are still not well understood. Based on the attributional model, this study investigated the association of criticism and Emotional Over-Involvement (EOI) with symptoms and functioning in At-Risk Mental State (ARMS) and First-Episode Psychosis (FEP) patients, and whether these associations were mediated by relatives׳ attributions of control and blame. Forty-four patients (20 ARMS and 24 FEP) and their relatives were included. Findings indicated that relatives׳ criticism was associated with positive, negative, and general symptoms. EOI was related to negative and general symptoms. Both indices were related with impaired functioning. Most of the relations between EE indices and illness severity were mediated by relatives׳ attributions of blame toward the patient. Relatives׳ self-blaming attributions and attributions of control over the disorder by either relatives or patients were not associated with patients׳ variables or EE. Findings highlight the importance of family emotional environment in the early stages of psychosis, as well as the mediating role that relatives׳ beliefs can exert in those relationships. Family interventions aimed to assist relatives to change attributions that blame patient should be included in clinical protocols in order to prevent the entrenchment of high-EE.

Assuntos

RESUMO

Selon l'analyse institutionnelle (Lourau), tout individu est impliqué par les institutions qu'il traverse et qui le traversent. Enseignante spécialisée exerçant dans une école élémentaire française, en classe spécialisée accueillant des enfants en situation de handicap mental, j'ai débuté une carrière de chercheuse à partir de mon questionnement quant aux violences qui s'exprimaient dans ma classe. Quand un praticien-chercheur entreprend une recherche sur son milieu professionnel, ses implication et surimplication opèrent un double mouvement, sur sa recherche et sur sa pratique. Ce mouvement a des effets sur ces deux milieux. Quels effets ont produit mon implication et ma surimplication dans ces deux champs professionnels ?

According to Institutional Analysis (Lourau), everyone is involved in the institutions through which he passes and that cross him. Special education teacher working in a French elementary school, in a class hosting children with mental disabilities, I began a career as a researcher from my questioning about the violences that were expressed in my class. When a practitioner-researcher undertakes a research on his workplace, its involvement and over-involvement operate a double movement on his research and practice. This movement has effects on these two workplaces. What impact my involvement and my over-involvement in these professional fields have they produced?

Assuntos

RESUMO

Selon l'analyse institutionnelle (Lourau), tout individu est impliqué par les institutions qu'il traverse et qui le traversent. Enseignante spécialisée exerçant dans une école élémentaire française, en classe spécialisée accueillant des enfants en situation de handicap mental, j'ai débuté une carrière de chercheuse à partir de mon questionnement quant aux violences qui s'exprimaient dans ma classe. Quand un praticien-chercheur entreprend une recherche sur son milieu professionnel, ses implication et surimplication opèrent un double mouvement, sur sa recherche et sur sa pratique. Ce mouvement a des effets sur ces deux milieux. Quels effets ont produit mon implication et ma surimplication dans ces deux champs professionnels ?.(AU)

According to Institutional Analysis (Lourau), everyone is involved in the institutions through which he passes and that cross him. Special education teacher working in a French elementary school, in a class hosting children with mental disabilities, I began a career as a researcher from my questioning about the violences that were expressed in my class. When a practitioner-researcher undertakes a research on his workplace, its involvement and over-involvement operate a double movement on his research and practice. This movement has effects on these two workplaces. What impact my involvement and my over-involvement in these professional fields have they produced?.(AU)

Assuntos