A study of three measures of expressed emotion in a sample of Chinese families of a person with schizophrenia

Emotional climate or expressed emotion (EE) has been examined in families of white descent who have a family member with schizophrenia but few studies have been conducted in Asian or Chinese families. This study tested the utility of the five-minute interview (FMI), adjective checklist (ACL) and family attitude scale (FAS) in a sample of Chinese family members in Beijing, in an attempt to introduce useful measures of EE into practice. A sample of 51 family members were interviewed and administered the three instruments. A total of 29.4% of families were found to be high-EE critical and 13.7% high-EE emotional over involvement using the FMI. The FAS and ACL prove internally consistent and were significantly correlated but not with the FMI. Cultural explanations for the discrepancies are offered. The measures have applicability in terms of understanding family relationships but further research and replication is necessary to deepen our understanding of EE in Chinese families.     

以家庭为中心的干预对精神分裂症照料者情感表达及监护水平的影响

目的探讨以家庭为中心的干预对精神分裂症照料者情感表达及监护水平的影响。方法将临床"痊愈"出院的263例精神分裂症患者分为研究组(132例)和对照组(131例),两组患者出院后均给予抗精神药物维持治疗和一般的心理教育,研究组在此基础上实施以家庭为中心的护理干预。在干预前和干预后1年,采用自制调查表评定两组照料者的监护方式和精神分裂症知识水平,采用坎伯威家庭问卷中文版评定照料者的情感表达,并比较两组患者的复发率。结果干预1年后,照料者认为患者对急性期、缓解期治疗的态度和监护方式以及对患者的日常生活和患者对外关系的监护方式方面,两组差异具有统计学意义(P0.01);研究组照料者的批评、敌对、情感过分参入评分及高情感表达的发生率均明显低于对照组(P0.01),热情性及赞扬性评分则明显高于对照组(P0.01);研究组患者复发率显著低于对照组(P0.05)。结论以家庭为中心的干预有助于改善精神分裂症患者的治疗态度,提高照料者家庭监护水平,降低患者疾病复发率。     

北京地区精神分裂症患者家属情感表达内容的研究

目的探讨北京地区精神分裂症患者家属情感表达的种类、对患者的监扩水平、对精神疾病认识和受歧视的体验。方法采用费氏CFl-CV访谈提纲,对216例精神分裂症患者家庭中的355名亲属进行访谈,按标准进行评定。结果有一种或-种以上的高情感表达170例。女性的情感过份参入明显多于男性。家属的监护水平以主动关心为主;他们的精神疾病知识极少;患者受歧视的体验明显高于家属。结论北京地区精神分裂症家属情感表达的种类和国外研究的结果相似,但情感过分参入偏高于国内研究报告。CFl-CV使我们对精神分裂症家庭增加了新的了解,可为今后开展家庭治疗提供有用的依据。     

The validity and reliability of the measurement of the concept 'expressed emotion' in the family members and nurses of Hong Kong patients with schizophrenia

This study aimed to test the validity and reliability of three measures of expressed emotion in a sample of family members and nurses of Hong Kong Chinese people with schizophrenia. Little research has been done in Hong Kong in relation to family expressed emotion (EE) and schizophrenia so the present study set out to pilot some measures that could become reliable and valid measures for future clinical studies. The Adjective Check List (ACL) and the Family Attitude Scale (FAS) were compared to EE ratings obtained after a brief interview. The ratings were made based on the conceptual framework of the Camberwell Family Interview, which includes the dimensions of criticism, hostility and emotional over-involvement. Twenty-one family members and their primary nurses participated in the study which revealed that 13 of the family members and 10 of the primary nurses were rated as high EE, either in terms of criticism, emotional over-involvement or both, based on the interview. The differences in the mean FAS scores between the high EE groups and the low EE group was large but not statistically significant, and there was a significant correlation between the FAS and the brief interview. The ACL revealed some interesting results in terms of the way relatives and nurses see themselves responding to the person with schizophrenia and vice versa. Recommendations for future studies and family education strategies are made .     

The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas

Although schemas play a central role in cognitive conceptualizations of personality disorders, research devoted to the assessment of schemas has been scarce. This article describes the preliminary validation of a measure of schemas relevant to personality disorders. The Schema Questionnaire (SQ) was developed using five independent samples (N=1,564). In study 1, factor analyses using a student sample revealed 13 primary schemas. A hierarchical factor analysis revealed three higher-order factors. In study 2, factor analyses using a patient sample revealed 15 primary schemas. The patient and student samples produced similar sets of primary factors which also closely matched the rationally developed schemas and their hypothesized hierarchical relationships (Young, 1991). The primary subscales were found to possess adequate test-retest reliability and internal consistency. In study 3, the SQ was found to possess convergent and discriminant validity with respect to measures of psychological distress, self-esteem, cognitive vulnerability for depression, and personality disorder symptoms.The authors would like to thank Dr. Jane Rigg for her assistance in data collection.     

家庭干预对农村慢性精神分裂症患者作用的随访研究

目的探讨家庭干预对农村慢性精神分裂症患者的康复作用和其经济效益。方法将 90例慢性精神分裂症患者随机分为干预组和对照组各 45例 ;对干预组定期进行以心理教育为主的家庭干预 1年。在入组时、入组第 6个月和第 12个月用SDSS、SAPS、SANS、MRSS对两组患者进行评估 ,且比较两组 1年的经济收入和支出情况。结果在家庭干预的第 6个月和 12个月时 ,干预组SDSS、SAPS、SANS、MRSS的均值 ,及间接医疗费用均低于对照组 ,复工收入高于对照组 (均为P <0 .0 0 1)。结论对农村慢性精神分裂症患者实施家庭干预治疗 ,既有利于控制其病情和提高其社会功能 ,又可减轻患者家庭的经济负担     

社区慢性精神分裂症家庭亲密度和适应性与患者精神症状的关系

目的探讨社区慢性精神分裂症家庭亲密度与适应性 ,及其与患者精神症状的相关性。方法应用家庭亲密度和适应性量表中文版 (FACESII CV)、阳性症状和阴性症状量表 (PANSS)对 5 1个社区精神分裂症家庭亲密度与适应性和患者的精神症状进行评定 ,与量表的正常参考值比较 ,进行多元相关分析。结果社区慢性精神分裂症患者家庭的适应性明显降低 (u <0 0 5或u <0 0 1) ;FACEII CV“拱极模式”中 ,平衡型比例明显减少 ,极端型比例增加 ,中间型比例无变化 ;实际亲密度得分与PANSS总分、阳性量表得分、一般精神病理量表得分呈负相关 (P <0 0 5 ) ;实际适应性得分与阳性量表得分呈负相关 (P <0 0 5 )。结论社区慢性精神分裂症家庭亲密度和适应性与患者精神症状密切相关 ,患者家庭的适应性降低。     

Genes and schizophrenia: a pseudoscientific disenfranchisement of the individual

The biological model of schizophrenia remains the dominant model within mental health services. It has a powerful influence on the culture of mental health services; providing the structure for the delivery and selection of mental health treatments. There is widespread acceptance of a genetic cause for schizophrenia. Acceptance of a genetic cause is inconsistent with a person-centred recovery-orientated approach. The following paper provides a rigorous review of the underpinning research that supports the genetic argument. Appraisal of family, twin and adoption studies uncovers serious flaws in the methodologies and statistical analyses used in studies. These flaws not only artificially inflate the genetic contribution to schizophrenia but also invalidate many of the findings. More recent micro-imaging techniques have also failed to find replicable and consistent findings indicating a clear genetic pathway to schizophrenia. Freed from the implied pessimism of an unmodifiable genetic cause for schizophrenia, mental health nurses can confidently work to instil hope with people that have a diagnosis of schizophrenia.     

Measuring the beliefs on alcohol craving by using craving beliefs questionnaire: preliminary results of its psychometric properties in a Turkish sample

Introduction: Therapist can assess patients’ maladaptive beliefs about drug via Craving Beliefs Questionnaire (CBQ), which was originally developed by Wright to measure beliefs about the craving phenomenon. The aim of the study is to assess the psychometric properties of CBQ and its usefulness in the patients with alcohol dependency. Method: The study population was consisted of 70 alcohol addict male patients. Beliefs about substance use questionnaire (BSU), craving beliefs questionnaire (CBQ), Beck anxiety inventory (BAI), clinical institute withdrawal assessment (CIWA), automatic thoughts questionnaire (ATQ) and dysfunctional attitudes scale (DAS) were used as the assessment tools. Results: The internal consistency of the CBQ for the alcohol dependent was adequate (Cronbach’s alpha 0.94). Item-total score correlations were between 0.50 and 0.84 for alcohol-dependent patients. The principal component analysis revealed one main factor. Positive correlations found between CBQ, and BSU, BAI and ATQ. In discriminant validity analysis, mean CBQ scores were found significantly higher than occasional drinkers and none-alcohol drinkers. Conclusion: Our results supported that the Turkish version of the CBQ has an adequate instrument for evaluating alcohol-related craving beliefs in alcoholic patients. However, further studies should be performed for assessing its validity in large number of social drinkers and alcohol-dependent patient.     

家庭护理干预对首发儿童精神分裂症病人疗效的影响

[目的]探讨家庭护理干预对首发儿童精神分裂症病人疗效的影响。[方法]选择在我院门诊就诊的60例首发儿童精神分裂症病人，随机分为常规组和研究组各30例。常规组给予一般的门诊服务，进行常规的用药指导及预约门诊。研究组除给予一般的门诊服务方式外，进行家庭护理干预，采取面谈、电话等形式与病人及家属进行心理沟通。8周后按我国现行4级疗效评定标准进行疗效评估。[结果]两组患儿治疗8周时，显效率比较有统计学意义（P〈0．05）。[结论1家庭护理干预能明显提高首发儿童精神分裂症病人的治疗效果，是药物治疗手段以外的重要辅助治疗措施，对病儿及家属尤为重要。     

家庭护理干预对首发儿童精神分裂症病人疗效的影响

[目的]探讨家庭护理干预对首发儿童精神分裂症病人疗效的影响.[方法]选择在我院门诊就诊的60例首发儿童精神分裂症病人,随机分为常规组和研究组各30例.常规组给予一般的门诊服务,进行常规的用药指导及预约门诊.研究组除给予一般.的门诊服务方式外,进行家庭护理干预,采取面谈、电话等形式与病人及家属进行心理沟通.8周后按我国现行4级疗效评定标准进行疗效评估.[结果]两组患儿治疗8周时,显效率比较有统计学意义(P＜0.05).[结论]家庭护理干预能明显提高首发儿童精神分裂症病人的治疗效果,是药物治疗手段以外的重要辅助治疗措施,对病儿及家属尤为重要.     

亲属探视护理干预对首次住院精神分裂症病人病情的影响

[目的]观察亲属探视护理干预对首次住院精神分裂症病人病情的影响.[方法]将101例首次住院的精神分裂症病人随机分为两组,对照组50例采取随意探视,观察组51例进行亲属探视的护理干预.采用护士用住院病人观测量表(NOSIE)和简明精神病量表(BPRS)进行效果评定病人的精神症状.[结果]观察组病人入院2周、8周BPRS评分低于对照组(P＜0.05);观察组病人NOSIE评分中激惹、抑郁及精神症状因子分低于对照组(P＜0.05).[结论]亲属探视护理干预对首次住院精神分裂症病人的病情有一定影响,适当选择探视时机探视,对改善病情有明显的辅助效果.     

Testing the psychometric properties of a Chinese version of the Level of Expressed Emotion scale

Expressed emotion of families of people with schizophrenia is useful and important to evaluate the effects of family interventions. This study tested the reliability and validity of a Chinese version of the Level of Expressed Emotion scale. This psychometric analysis included tests of content validity and reliability, and an exploratory factor analysis. Results indicated that the Chinese version had a high level of equivalence with the original English version and demonstrated good internal consistency and test-retest reliability. The refined 52-item Chinese version consisted of four factors, indicating satisfactory correlation with two theoretically relevant scales. The Chinese version appears psychometrically sound as a measure of schizophrenic patients' perceptions of their family members' expressed emotion.     

家庭关系对精神分裂症病人康复的影响

目的探讨家庭关系对精神分裂症病人康复的影响.方法对具有不同家庭关系背景的405例精神分裂症病人进行为期3年的随访对照研究,并用BPRS、SDSS量表对病人的精神症状及社会功能进行评定.结果在3年的随访期间家庭关系不同的3组病人复发恶化率及BPRS、SDSS量表评分无明显差异;多因素分析结果表明,本次病程是影响精神分裂症康复的最主要因素,家庭关系是主要影响因素之一.结论精神分裂症病人的康复受综合因素的影响,良好的家庭关系有助于病人的康复.