Butzlaff R L, Hooley J M
Department of Psychology, Harvard University, Cambridge, Mass 02138, USA.
Arch Gen Psychiatry. 1998 Jun;55(6):547-52. doi: 10.1001/archpsyc.55.6.547.
Expressed emotion (EE) is a measure of the family environment that has been demonstrated to be a reliable psychosocial predictor of relapse in schizophrenia. However, in recent years some prominent nonreplications of the EE-relapse relationship have been published. To more fully address the question of the predictive validity of EE, we conducted a meta-analysis of all available EE and outcome studies in schizophrenia. We also examined the predictive validity of the EE construct for mood disorders and eating disorders.
An extensive literature search revealed 27 studies of the EE-outcome relationship in schizophrenia. Using meta-analytic procedures, we combined the findings of these investigations to provide an estimate of the effect size associated with the EE-relapse relationship. We also used meta-analysis to provide estimates of the effect sizes associated with EE for mood and eating disorders.
The results confirmed that EE is a significant and robust predictor of relapse in schizophrenia. Additional analyses demonstrated that the EE-relapse relationship was strongest for patients with more chronic schizophrenic illness. Interestingly, although the EE construct is most closely associated with research in schizophrenia, the mean effect sizes for EE for both mood disorders and eating disorders were significantly higher than the mean effect size for schizophrenia.
These findings highlight the importance of EE in the understanding and prevention of relapse in a broad range of psychopathological conditions.
情感表达（EE）是衡量家庭环境的一种指标，已被证明是精神分裂症复发的可靠社会心理预测因素。然而，近年来发表了一些关于EE与复发关系的显著非重复性研究。为了更全面地探讨EE的预测效度问题，我们对精神分裂症中所有可用的EE与结局研究进行了荟萃分析。我们还研究了EE结构对心境障碍和进食障碍的预测效度。
广泛的文献检索揭示了27项关于精神分裂症中EE与结局关系的研究。使用荟萃分析程序，我们整合了这些研究的结果，以估计与EE与复发关系相关的效应量。我们还使用荟萃分析来估计与EE对心境障碍和进食障碍相关的效应量。
结果证实，EE是精神分裂症复发的一个显著且有力的预测因素。进一步分析表明，EE与复发的关系在病程较长的精神分裂症患者中最为强烈。有趣的是，尽管EE结构与精神分裂症的研究联系最为紧密，但EE对心境障碍和进食障碍的平均效应量显著高于对精神分裂症的平均效应量。
这些发现凸显了EE在理解和预防广泛的精神病理状况复发中的重要性。
