Lam D, Giles A, Lavander A
Psychology Department, Institute of Psychiatry, DeCrespigny Park, London, UK.
J Intellect Disabil Res. 2003 Sep;47(Pt 6):456-63. doi: 10.1046/j.1365-2788.2003.00512.x.
Expressed emotion (EE) has been found to be high in families with children suffering from conduct disorder as well as a variety of childhood psychiatric disorders. Expressed emotion has been associated with high levels of stress in carers. However, behavioural problems in children do not automatically lead to stress in carers. Carers' beliefs and behaviour could affect how they appraise and cope with their child's behaviour. Furthermore, the perceived adequacy of social support can also be an important factor in determining the family's level of stress. The study investigates the relationship between EE variables and carers' appraisal and coping with the child's behaviour, stress and social support.
Forty-seven carers were recruited from schools for moderate to severe learning disabilities. Carers filled in questionnaires and took part in the Camberwell Family Interview for EE status. Carers' EE status was determined by a rater blind to the carers' questionnaires scores.
There was no difference between high and low EE groups in the descriptive information of the child's independence, communication skills, or the frequency of behavioural problems. However, high EE carers appraised more of their children's behaviour as definite problems and their available social support to be less adequate. High warmth was found to relate to more positive reappraisal and less escape-avoidance coping. A multiple regression analysis indicated that carers' EE, psychological well-being, appraisal of their children's behaviour, their children's communication skills and respite usage predicted 62% of the variance in their perceived stress scores.
It is important to consider optimal use of respite care and psychosocial intervention to encourage positive appraisal and problem solving.
研究发现，在患有品行障碍以及各种儿童精神疾病的孩子的家庭中，情感表达（EE）水平较高。情感表达与照顾者的高压力水平有关。然而，孩子的行为问题并不会自动导致照顾者产生压力。照顾者的信念和行为会影响他们对孩子行为的评估和应对方式。此外，感知到的社会支持是否充足也是决定家庭压力水平的一个重要因素。本研究调查了情感表达变量与照顾者对孩子行为的评估、应对方式、压力和社会支持之间的关系。
从学校招募了47名照顾中重度学习障碍儿童的照顾者。照顾者填写问卷，并参加了关于情感表达状况的坎伯韦尔家庭访谈。照顾者的情感表达状况由一名对照顾者问卷得分不知情的评估者确定。
在孩子的独立性、沟通能力或行为问题发生频率的描述性信息方面，高情感表达组和低情感表达组之间没有差异。然而，高情感表达的照顾者将更多孩子的行为评估为明确的问题，并且认为自己可获得的社会支持不太充足。研究发现，高温暖度与更积极的重新评估和更少的逃避应对方式有关。多元回归分析表明，照顾者的情感表达、心理健康、对孩子行为的评估、孩子的沟通能力以及临时照顾的使用情况，预测了他们感知到的压力得分中62%的方差。
重要的是要考虑优化使用临时照顾和心理社会干预措施，以鼓励积极的评估和问题解决。
