The research proposed involves a series of interrelated studies concerned with family factors associated with the onset, course and treatment of major mental disorders, with particular emphasis upon schizophrenia. The methodology developed by our research group is utilized to study the intrafamilial processes of communication deviance (CD), expressed emotion (EE), and affective style (AS). A number of studies are proposed which study the interrelationships among these variables and their relative prognostic validity in different samples. One of these studies relates to family factors associated with the onset of schizophrenia-spectrum disorders and involves a fifteen-year follow-up of a cohort of 65 cases studied originally in adolescence. This study will evaluate the role of CD, EE and AS in predicting the course of psychiatric disorders since adolescence. Three other studies focus on family factors associated with the course of mental disorders in populations of-1) recent onset, young American schizophrenics; 2) bipolar patients. Following assessment of family interaction, patients will be followed up for two years to determine whether and in what ways parental and patient attributes relate to the longitudinal course of each disorder. 3) The third study proposed is designed to evaluate the impact of a brief psycho-educational program in families containing young schizophrenic patients on relatives' attitudes, intrafamilial behavior and patient symptomatology during a critical six-week period after discharge and return to home. The EE status of the relatives will also be examined as a predictor of their response to the psychoeducational program.
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