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AO1
Builds on the psychodynamic focus on dysfunctional families but proposes that the
family plays a part in the `course' rather than the `cause' of schizophrenia.
High expressed emotion is shown by hostility, criticism, over-involvement and
concern.
Theory: High EE influences the development of schizophrenia rather than its onset.
So EE may act like a trigger rather than completely causing it.…read more

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Two main ways EE within a family can
affect someone with schizophrenia:
· Friends and relatives find · Find the changes very
dealing with some problems upsetting and try to look
associated with psychotic after the person like a child.
experience frustrating and · While it is understandable
difficult. and can be helpful in the
· Especially short-term, during
embarrassing/disruptive recovery, the emotionally
behaviour. involved reaction can lead
· Become critical or actively to dependence in the
hostile towards the individual and exhaustion in
individual. the carer.…read more

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Either of the attitudes in carers, if they become
extreme, have been found to lead poorer
outcomes and an increased likelihood of a return
to psychotic experiences.
People living in more supportive, tolerant, low EE
environments have a lower likelihood of a return to
psychotic experiences and a better general
outcome.…read more

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AO2: Evidence to Support
High EE expressed
Classified families as either considerable emotion (higher
Brown et al (1966)
high or low EE families. levels of concern or hostility
towards the patient).
Suggests that high EE families
act as a trigger and influences
Found 58% of patients who the development of
Only 10% relapsed after
returned to high EE families schizophrenia as 58% who
returning to low EE families.
relapsed. returned to high EE compared
to 10% of low EE relapsed, so
there must be some effect.…read more

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AO2: Evidence to Support
Also looked at
Included data
time spent in This suggests
on whether or
face-to-face that EE plays a
not patient was
contact with clear role and it
Found similar on medication.
relatives after could be a
results: 51% Relapse rates
Vaughan & Leff discharge and factor in the
relapse in high increased to
(1976) found relapse course of
EE and only 92% in high EE
increased as schizophrenia
13% in low EE. homes with
contact as 92% is very
increased
increased with high
contact and no
high EE percentage.
medication.
relatives.…read more

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