King S
Associate Professor, Department of Psychiatry, McGill University, Montreal, Canada.
Schizophr Res. 2000 Sep 29;45(1-2):65-78. doi: 10.1016/s0920-9964(99)00174-7.
The purpose of this study was to determine the most likely direction of influence between the symptom severity in schizophrenic young adults and the expressed emotion (EE) of their mothers. Specifically, the stability and cross-lagged effects of mothers' critical comments (CC) or emotional overinvolvement (EOI) and the severity of four symptom clusters were examined. Twenty-eight patients and their mothers were interviewed three times at 9 month intervals. Data were subjected to a form of structural equation modeling: cross-lagged panel analysis. Results suggest that maternal CCs and EOI both tend to be influenced by the patient's total symptom severity and are influenced significantly by negative symptoms, but not by positive symptoms. Also, the more severe the hostile-uncooperative symptoms in the patient, the more critical the mothers become over time. However, the greater the mother's EOI at time 1, the less severe the patient's hostile-uncooperative symptoms at time 3. The usual implication of the association between high EE and relapse, which was also found in this sample, is that high EE causes symptom exacerbation. The results of the current study suggest that CCs and EOI coded from the CFI do not reflect a noxious environment: rather, they appear to be more effect than cause.
本研究的目的是确定精神分裂症青年患者的症状严重程度与其母亲的情感表达（EE）之间最可能的影响方向。具体而言，研究考察了母亲的批评性评论（CC）或情感过度卷入（EOI）与四个症状群严重程度的稳定性和交叉滞后效应。28名患者及其母亲每隔9个月接受三次访谈。数据采用一种结构方程模型形式进行分析：交叉滞后面板分析。结果表明，母亲的CC和EOI都倾向于受患者总体症状严重程度的影响，且受阴性症状的显著影响，但不受阳性症状的影响。此外，患者的敌对-不合作症状越严重，随着时间推移母亲的批评越严厉。然而，母亲在第1阶段的EOI越高，患者在第3阶段的敌对-不合作症状就越不严重。本样本中也发现了高EE与复发之间关联的常见含义，即高EE导致症状加重。当前研究结果表明，从CFI编码的CC和EOI并不反映有害环境：相反，它们似乎更多是结果而非原因。
