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Tijdschrift voor Psychiatrie 43 (2001) 9, 611 - 619

New research

Expressed emotion in staff - patient relationships in sheltered living

G. van Humbeeck, C. van Audenhove, M. De Hert, J. Heyrman, J. Peuskens, G. Pieters, G. Storms, H. Vertommen

background There is a well-established tradition in studying the impact of expressed emotion (ee) of relatives on the course of severe mental illnesses such as schizophrenia. Expressed emotion refers to the affective attitude and behavior - criticism, hostility and emotional overinvolvement - of a member of the family towards a patient. Not only relatives can have a high ee score, staff members can react critical, hostile and/or overinvolved, too.
aim To determine how the patient and his professional caregiver experience their relationship and to investigate whether there is emotional overinvolvement.
method In this study ee was assessed in 56 professional caregivers and 56 patients suffering from schizophrenia or another psychotic disorder, and living in sheltered houses in Flanders. ee of the professionals was assessed by means of the Camberwell Family Interview (cfi) and the Perceived Criticism Scale (pcs). The residents were subjected to the Perceived Criticism Scale (pcs) only. results According to the cfi 16 percent of the professionals was characterized by a high amount of ee . Based on the pcs, 34 percent of the professionals was considered as highly critical by the residents. By comparing the two instruments, a significant positive association was found between the amount of critical comments and the hostility on the cfi and the perceived criticism on the pcs. discussion These results support the hypothesis that in some staff-patient relationships a high amount of ee can occur. A high ee may have a negative effect on patients. Therefore it is important that caregivers receive information about how to deal with patients in a low ee-manner.

keywords expressed emotion, professional caregivers, sheltered living, schizophrenia