1) Specific Aims: To transculturally replicate British and Anglo-American studies which found levels of familial expressed emotion (EE) to be the single most influential predictor for the outcome of schizophrenic illness. The study has been designed to test this relationship among a different cultural group--unacculturated Spanish-speaking Mexican-American--who have returned to live with their families following discharge from psychiatric hospitals. The potency of the EE index as a cross-culturally valid prognostic indicator will be analyzed with reference to two other variables found to be strongly associated with patterns of relapse: the degree of patients' contact time with family members, as well as adherence to prescribed anti-psychotic medication. Addtionally, schizophrenic outcome will be evaluated in relationship to levels of premorbid adjustment of the patient, as well as measures of communication deviance among key relatives. Analyses of the nature and meaning of expressed emotion within the Mexican-American context, as well as strategies for coping and adaptation to the stresses generated by living with schizophrenic illness within family settings, will also be documented. 2) Methodology: Data analytic plans for hypothesis testing of the relationship of EE to schizophrenic outcome include three levels of analyses: replication of quantitative strategies used by previous researchers; multivariate analyses to test hypotheses about relations between EE, clinical outcome, and potentially important intervening variables; and exploratory univariate analyses. Examination of the nature of EE and styles of coping with schizophrenic illness will be accomplished through qualitative methods, including content analyses of collected materials. 3) Health relatedness: Important clinical guidelines for the reduction of schizophrenic morbidity are expected to be derived from the results. Specifically, the findings will be utilized to design an educative family problem-solving intervention for use in Hispanic-American families coping with major mental disorders. It is expected that a culturally-sensitive application of the strategy described by Falloon et al. (1982) would be appropriate.
| Jenkins, J H; Karno, M (1992) The meaning of expressed emotion: theoretical issues raised by cross-cultural research. Am J Psychiatry 149:9-21 |
| Jenkins, J H (1988) Ethnopsychiatric interpretations of schizophrenic illness: the problem of nervios within Mexican-American families. Cult Med Psychiatry 12:301-29 |
| Jenkins, J H (1988) Conceptions of schizophrenia as a problem of nerves: a cross-cultural comparison of Mexican-Americans and Anglo-Americans. Soc Sci Med 26:1233-43 |
| Karno, M; Jenkins, J H; de la Selva, A et al. (1987) Expressed emotion and schizophrenic outcome among Mexican-American families. J Nerv Ment Dis 175:143-51 |
| Jenkins, J H; Karno, M; de la Selva, A et al. (1986) Expressed emotion, maintenance pharmacotherapy, and schizophrenic relapse among Mexican-Americans. Psychopharmacol Bull 22:621-7 |
