Jenkins J H, Karno M
Department of Anthropology, Case Western Reserve University, School of Medicine, Cleveland, OH 44106.
Am J Psychiatry. 1992 Jan;149(1):9-21. doi: 10.1176/ajp.149.1.9.
The finding that expressed emotion is associated with the course of psychiatric disorder has generated a great deal of clinical and research interest in expressed emotion as an important risk factor. Theoretical elucidation of the construct of expressed emotion has lagged considerably behind this interest, however. The authors contribute to a dialogue on what is inside the "black box" called expressed emotion. They argue that cross-cultural research can provide an empirical basis for the theoretical grounding of expressed emotion factors. A comparative approach reveals that the construct of expressed emotion is essentially cultural in nature. The constellation of emotions, attitudes, and behaviors that are indexed by the expressed emotion method represent cross-culturally variable features of family response to an ill relative. Questions surrounding the cultural validity of the construct of expressed emotion, the qualitative dimensions of expressed emotion, and statistically significant cross-cultural variations in expressed emotion profiles are discussed. Finally, the authors provide an outline of diverse (cultural, psychobiological, social-ecological) features of expressed emotion. Anthropological analysis of expressed emotion reveals that although expressed emotion indexes a Pandora's box of diverse features, culture provides the context of variation through which these factors are most productively analyzed.
表达性情绪与精神疾病病程相关这一发现，引发了临床和研究领域对表达性情绪作为重要风险因素的广泛兴趣。然而，对表达性情绪这一概念的理论阐释却远远落后于这种兴趣。本文作者参与了关于所谓表达性情绪“黑匣子”内部情况的讨论。他们认为跨文化研究可为表达性情绪因素的理论基础提供实证依据。一种比较方法显示，表达性情绪这一概念本质上具有文化属性。通过表达性情绪方法所界定的情绪、态度和行为组合，代表了不同文化背景下家庭对患病亲属反应的可变特征。文中讨论了围绕表达性情绪概念的文化效度、表达性情绪的质性维度以及表达性情绪特征在统计学上显著的跨文化差异等问题。最后，作者概述了表达性情绪的多样（文化、心理生物学、社会生态）特征。对表达性情绪的人类学分析表明，尽管表达性情绪涵盖了一系列多样的特征，但文化提供了变化的背景，通过这一背景能最有效地分析这些因素。
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